Vital Signs by Age
You cannot recognise an abnormal vital sign in a child without knowing what is normal for that age. The PALS course uses reference ranges like these throughout its assessment and cases.
The hypotension thresholds
Systolic blood pressure below: 60 mmHg in term neonates (0 to 28 days); 70 mmHg in infants (1 to 12 months); 70 + (2 x age in years) mmHg in children 1 to 10 years; 90 mmHg in children over 10.
| Age | Heart rate per minute |
|---|---|
| Newborn to 3 months | about 85 to 205 |
| 3 months to 2 years | about 100 to 190 |
| 2 to 10 years | about 60 to 140 |
| Over 10 years | about 60 to 100 |
| Age | Breaths per minute |
|---|---|
| Infant | about 30 to 53 |
| Toddler | about 22 to 37 |
| Preschool | about 20 to 28 |
| School age | about 18 to 25 |
| Adolescent | about 12 to 20 |
Reference ranges vary slightly between sources; these follow the AHA PALS reference tables. Sleep, fever, pain and anxiety all change the numbers.
The thresholds above define hypotension. Because children compensate, a normal blood pressure does not rule out shock — see compensated shock.
They feed the systematic approach, the respiratory and shock categories, and the sinus tachycardia vs SVT decision. A falling heart rate in a sick child is often a sign of hypoxia — see bradycardia.
This guide summarises what the PALS course teaches, for education only. It is not a clinical protocol: follow the current American Heart Association guidelines, linked below, and your institution’s paediatric policies.
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Roughly 100 to 190 when awake for ages 3 months to 2 years, per the AHA PALS reference ranges.
For children 1 to 10 years, systolic BP below 70 + (2 x age in years) mmHg.
Systolic BP below 70 mmHg for infants aged 1 to 12 months.
Yes, in compensated shock.
Slightly; these follow the AHA PALS tables.
Paediatric emergencies are learned by doing. Safety First Medical Services is an American Heart Association training centre on Al Reem Island, Abu Dhabi, with HeartCode, classroom and on-site PALS and a two-year AHA PALS Provider eCard.
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What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.
Last reviewed by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.