Acceptable Ranges For Physiological Variables

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RCH  >  Health Professionals  >  Clinical Practice Guidelines  >  Acceptable ranges for physiological variables

In this section

• About Clinical Practice Guidelines
• CPG index
• Paediatric Improvement Collaborative
• Nursing Guidelines
• Paediatric palliative care guidelines
• Parent resources
• Retrieval services
• CPG Committee Calendar
• CPG information
• Other resources
• CPG feedback

Acceptable ranges for physiological variables Acceptable ranges for physiological variables

• PIC Endorsed

• See also

  Sepsis Bradycardia during sleep Recognition of the seriously unwell neonate and young infant Hypertension

  Key points

  1. The table below provides acceptable ranges for systolic BP, heart rate and respiratory rate for unwell children
  2. Patterns of change in physiological variables are as important, as the thresholds shown here

  Background

  • There are many publications giving normal or acceptable ranges for physiological variables in children
  • Published values are quite disparate and probably reflect differing populations and assessment methods

  Assessment

  • The pattern of change in variables is often more important than the value itself. For example, a heart rate that is steadily rising through the acceptable range should trigger attention
  • Repeated observations are essential
  • Look at previous measurements in the same child, earlier in the admission, or during prior admissions
  • Consider measurements in the clinical context of the child
  • These values are generally the 5th and 95th percentile values for each paediatric variable, rounded to more workable values and consistent with Australian paediatric hospital observation charts

  Acceptable ranges for physiological variables

  Age	Approximate Weight (kg)	Systolic BP (mmHg)	Heart Rate (Beats/minute)	Respiratory Rate (Breaths/minute)
  Term	3.5	60-95	120-170	25-60
  3 months	6	60-105	115-170	25-60
  6 months	8	75-105	110-170	20-55
  1 year	10	70-105	105-150	20-45
  2 years	12	70-105	95-150	20-40
  4 years	15	75-110	80-150	17-30
  6 years	20	80-115	75-140	16-30
  8 years	25	80-115	70-130	16-30
  10 years	30	85-120	60-130	15-25
  12 years	40	90-120	65-120	15-25
  14 years	50	90-125	60-115	14-25
  16 years	60	90-130	60-115	14-25
  17+ years	65	90-135	60-115	14-25

  For emergency advice and paediatric or neonatal ICU transfers, see Retrieval services

  Additional Resources

  • NSW Health Observation charts Between the Flags
  • QLD The Children’s Early Warning Tool
  • Victorian Health Observation Charts VICTOR charts

  Last updated July 2023

• Reference List

  1. Bonafide CP et al. Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children. Pediatrics 2013;131(4): e1150–7.
  2. Dionne JM et al. Hypertension in infancy: diagnosis, management and outcome. Pediatr Nephrology 2012;17–32.
  3. Fanaroff JM, Fanaroff AA. Blood pressure disorders in the neonate: Hypotension and hypertension. Semin Fetal Neonatal Med. 2006;174–81.
  4. Flynn JT et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents Pediatrics 2017 140(3) 1904 
  5. Gemelli M et al. Longitudinal study of blood pressure during the 1st year of life. Eur J Pediatr. 1990;318–9.
  6. Haque IK et al. Analysis of the evidence for the lower limit of systolic and mean arterial pressure in children. Pediatr Crit Care Med. 2007;8(2):138–44.
  7. Lurbe E et al. Management of high blood pressure in children and adolescents: recommendations of the European society of hypertension. J Hypertens. 2009;27(9):1719–42.
  8. Sepanski RJ et al. Pediatric Vital Sign Distribution Derived From a Multi-Centered Emergency Department Database. Front Pediatr. 2018;6, 
  9. Tibballs J et al. Reduction of paediatric in-patient cardiac arrest and death with a medical emergency team: Preliminary results. Arch Dis Child. 2005;90(11):1148–52.

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