Related Experiment Video

Updated: Jun 23, 2026

Measuring Cardiac Autonomic Nervous System ANS Activity in Children
09:45

Measuring Cardiac Autonomic Nervous System ANS Activity in Children

Published on: April 29, 2013

21.0K

Time to change the reference ranges of children's physiological observations in emergency care? A prospective study

Louise Brennan1,2, Calvin Heal3, Stephen Brown4

  • 1Lead Employer, St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, United Kingdom.

Journal of Paediatrics and Child Health
|January 16, 2023
PubMed

Insights

Current guidelines for pediatric sepsis may overestimate abnormal heart rates in children. This study suggests established normal heart rate ranges are too low, leading to unnecessary high-risk classifications.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Physiology
  • Infectious Disease Diagnostics

Background:

  • High heart and respiratory rates are critical for identifying serious bacterial infections and sepsis in children.
  • The evidence supporting current 'abnormal' thresholds for these vital signs is questionable.
  • Accurate reference ranges are essential for timely and appropriate pediatric care.

Purpose of the Study:

  • To establish the distribution of heart and respiratory rates in children using a large dataset.
  • To compare pediatric vital sign distributions with Advanced Paediatric Life Support (APLS) guidelines.
  • To inform the debate on appropriate 'normal' ranges for pediatric heart and respiratory rates.

Main Methods:

  • Prospective study design.
  • Utilized anonymized patient data from electronic health records.
  • Included children aged 0-16 years from UK emergency and urgent care settings.

Main Results:

  • Children's heart and respiratory rates were consistently higher than APLS guidance thresholds.
  • A significant proportion of children exceeded 'severe' cut-off values, varying by age.
  • Respiratory rate distributions aligned more closely with existing guidelines and data.

Conclusions:

  • Current APLS and other normal heart rate ranges for children may be set too low.
  • Existing guidelines may classify too many children as having 'abnormal' measurements.
  • Respiratory rate guidelines appear more consistent with current data.
Abstract

Keywords:
emergency medicinegeneral paediatricsinfectious diseasesintensive care

More Related Videos

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies10:38

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Published on: January 16, 2019

20.3K
How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children07:27

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

Published on: August 19, 2020

11.6K

Related Concept Videos

Introduction to Vital Signs01:25

Introduction to Vital Signs

Vital signs are physiological measurements that help key into the status of the body's essential functions. These include body temperature, pulse rate, respiratory rate, and blood pressure, commonly abbreviated as T, P, R, and BP. Some healthcare settings also consider oxygen saturation (SpO2) and, in specific contexts, pain and level of consciousness as additional vital signs.
Vital signs help healthcare professionals assess an individual's well-being and detect any functional changes or...
Guidelines For Measuring Vital Signs01:19

Guidelines For Measuring Vital Signs

Following these guidelines can help nurses accurately measure vital signs, assess changes in patient conditions, and provide timely treatment when necessary. Adhering closely to the guidelines ensures the accuracy and reliability of the results.
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
Temperature Measurement Sites01:14

Temperature Measurement Sites

A thermometer measures body temperature. The common sites for measuring body temperature are the oral cavity, axillary region, temporal artery, and skin surface, such as the forehead, abdomen, and axilla. True core body temperature is assessed in the rectum, tympanic membrane, pulmonary artery, esophagus, and urinary bladder.
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.