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What is 'normal?' Evaluating vital signs.
Debra Van Kuiken1, Myra Martz Huth
1Xavier University, Cincinnati, OH, USA.
Pediatric Nursing
|December 7, 2013
Summary
Routine vital sign (VS) assessments in young children lack evidence. Current data on normal VS parameters and significant changes are inconsistent, highlighting a need for research to guide clinical practice.
Area of Science:
- Pediatric critical care
- Evidence-based practice
- Clinical assessment
Background:
- Routine vital sign (VS) assessment frequency in pediatric patients is often standard practice, irrespective of clinical need.
- Pediatric nurse leaders have raised concerns regarding the frequency of VS monitoring.
- Existing literature lacks direct evidence on optimal VS assessment frequency in children.
Purpose of the Study:
- To determine "normal" vital sign parameters in pediatric patients aged 1 to 5 years.
- To define significant changes in vital signs for this age group.
- To address the need for evidence-based guidelines on VS assessment frequency.
Main Methods:
- A comprehensive literature search was conducted, including systematic reviews, case-control studies, descriptive studies, and textbooks.
- Five systematic reviews, one case-control study, and five descriptive studies focusing on normative values were analyzed.
- Six articles on pediatric early warning signs (PEWS) were also reviewed.
Main Results:
- Systematic reviews indicate that vital signs are poorly defined and unreliable indicators of physical deterioration in young children.
- Normative VS data are inconsistent and often contradictory.
- Parameters for significant VS change lack consistency in the PEWS literature, with a scarcity of high-quality research.
Conclusions:
- There is a significant lack of consistent, high-quality research on normative VS values for children.
- Evidence guiding the frequency of VS assessments and the use of indicators for decline in hospitalized children is insufficient.
- Clinicians require research-based guidelines to inform VS assessment decisions and interventions.
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