Vitals or the vital signs are clinical measurements that indicate the state of a person’s essential body functions. These specifically include pulse rate, body temperature, respiration rate (rate of breathing), and blood pressure. Any deviation from normal values should be taken seriously, and you should notify your doctor.
Although weight and height are measured along with vitals are important measurements, they are not considered vital signs.
|Temperature||Oral (preferred)||95.9-99.5 °F|
|Pulse (heart rate)||Below the angle of the jaw, the inside of the wrist (thumb side), elbow, or groin||65-120 beats per minute (depends on various factors, such as physical activity and time since last meal)|
|Respiratory rate||Chest heaving as one breath||12-30 breaths per minute|
|Blood pressure (BP)||Right arm||
*Weight and height are not considered vital signs.
How to measure your child’s vitals
Vital signs are usually only measured when a child has certain conditions.
Your pediatrician may advise measuring your child’s temperature if they are running a fever and tell you to keep a temperature chart. Temperature charting involves measuring the child’s temperature (ideally oral temperature) every 4 hours and making a note. This helps your doctor understand the child’s fever pattern and assess whether there are spikes.
To measure your child’s oral temperature:
- Ask your child to open their mouth.
- Slip the end of the digital thermometer under the tongue.
- Make sure the child closes their lips around the thermometer.
- Remove it when it beeps and note the temperature.
An aural, rectal or forehead thermometer can be used as well. The manufacturer of each kind of thermometer provides information on how to use it.
High fever, pain, dehydration, and certain cold medications are the most common reasons why the 7-year-old has a high pulse. Other causes of high pulse rate are an asthma attack, anaphylaxis, anxiety, anemia, or certain heart or lung conditions.
A lower heart rate may be caused by what is called a vagal tone. This is nothing to worry about, as it’s common among many kids. Other causes of low heart rate include congenital heart disease.
To take your child’s pulse:
- Make sure the child is seated for at least 5 minutes in a chair.
- Press two fingers gently at the side of the neck below the jawline.
- Never press both sides of the neck simultaneously to feel for a pulse.
- Alternatively, you can measure pulse rate by touching the radial artery at the wrist in line with the child’s thumb.
- Take a reading for one minute.
Measuring respiratory rate is important in children who have frequent asthma and bronchitis episodes. An increased rate of respiration along with difficulty in breathing requires immediate medical help.
Aside from increased respiratory rate, contact your pediatrician if there is any abnormality, such as noisy breathing or a recession of skin under the ribs or over the collar bone.
Unlike adults, more children suffer from low blood pressure as opposed to higher blood pressure. However, about 3.5% percent of children in the U.S. suffer from high blood pressure, and the increase in childhood obesity has necessitated blood pressure monitoring in kids.
The most common causes of low blood pressure in a child are fever, dehydration, and septic shock. Causes of high blood pressure in a child include heart conditions, kidney disease (nephrotic syndrome or glomerulonephritis), genetic conditions, or hormonal disorders (Cushing syndrome, excessive secretion of growth hormone, hypothyroidism, etc.).
When measuring blood pressure in a child, don’t use the adult cuff monitor as it will give incorrect readings. The ideal pediatric cuff size is one with a bladder length of 80% and a width that is at least 40% of the arm circumference. For a 7-year-old, the cuff with an arm circumference of 16-22 cm is recommended by the American Heart Association.
To measure your child’s blood pressure:
- Make sure the child is seated comfortably in a chair, as an unsupported back may increase diastolic blood pressure.
- Make sure the child’s arm is supported at heart level.
- Tie the cuff two fingers above the elbow crease.
- Make sure the blood pressure cuff is inflated and then deflated.
- Note the two values of blood pressure (systolic and diastolic).
- If the cuff size is correct, an automated blood pressure machine may be used.
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Cincinnati Children's Hospital Medical Center. Growth, Range of Height and Weight. https://www.cincinnatichildrens.org/health/g/normal-growth
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