Pulse Rate : Grading of Pulses

    • Pulse Rate
      • Grading of Pulses
Grade Description
0 Not palpable
+1 Difficult to palpate, thready, weak, easily obliterated with pressure
+2 Difficult to palpate, may be obliterated with pressure
+3 Easy to palpate, not easily obliterated with pressure (normal)
+4 Strong, bounding, not obliterated with pressure
        • Newborn: 110 to 160/min (depending on activity)
        • 1 week to 3 months:107 to 180/min (depending on activity)
        • 2 to 10 years: 70 to 110/min (depending on activity)
        • 10 years and older: 50 to 90/min (depending on activity)
    • Respirations
      • Count the respiratory rate in children in the same manner as for adult patients
      • However, in infants, observe abdominal movements, because respirations are primary diaphragmatic
        • Newborn to 1 year: 30 to 35/min
        • 1 to 2 years: 25 to 30/min
        • 6 to 12 years: 19 to 21/min
        • 12 years and older: 16 to 19/min
    • Blood pressure
      • Should be measured annually in children 3 years of age through adolescence and in children with symptoms of hypertension, children in emergency departments and intensive care units, and high-risk infants.
      • Orthostatic Hypotension
        • Also called postural hypotension or orthostatic intolerance
        • Manifests as syncope (fainting), vertigo (dizziness), or lightheadedness and is caused by decreased blood flow to the brain (cerebral hypoperfusion)
        • Normally blood flow to the brain is maintained at a constant level by several compensating mechanisms that regulate systemic BP.
        • When one assumes a sitting or standing position from a supine or recumbent position, peripheral capillary vasoconstriction occurs, and blood that was pooling in the lower vasculature is returned to the heart for redistribution to the head and remainder of the body.
        • Leading to vertigo or syncope
        • One of the most common causes of OH is hypovolemia
          • May be induced by medications, such as diuretics, vasodilator medications, and prolonged immobility or bed rest.
        • Other causes of OH include: 
          • Dehydration
          • Diarrhea
          • Emesis
          • Fluid loss from sweating and exertion
          • Alcohol intake
          • Dysrhythmias
          • Diabetes mellitus
          • Sepsis
          • Hemorrhage
      • Width of cuff should cover 40% of the arm and 80-100% of the upper arm without overlapping 
Female Males
Systolic (mmHg) Diastolic (mmHg) Systolic (mmHg) Diastolic (mmHg)
Infants 65 to 78 41 to 52 65 to 78 41 to 52
1 Year 83 to 114 38 to 67 80 to 114 34 to 66
3 Years 86 to 117 47 to 76 86 to 120 44 to 75
6 Years 91 to 122 54 to 83 91 to 125 53 to 84
10 Years 98 to 129 59 to 88 97 to 130 58 to 90
16 Years 108 to 138 64 to 93 111 to 145 63 to 94

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