Pediatric Respiratory Rates

Age Rate (breaths per minute)

Infant (birth–1 year) 30–60

Toddler (1–3 years) 24–40

Preschooler (3–6 years) 22–34

School-age (6–12 years) 18–30

Adolescent (12–18 years) 12–16

Pediatric Pulse Rates

Age Low High
Infant (birth–1 year) 100 160

Toddler (1–3 years) 90 150

Preschooler (3–6 years) 80 140

School-age (6–12 years) 70 120

Adolescent (12–18 years) 60 100

Pulse rates for a child who is sleeping may be 10 percent lower
than the low rate listed.

Low-Normal Pediatric Systolic Blood Pressure

Age* Low Normal
Infant (birth–1 year) greater than 60*

Toddler (1–3 years) greater than 70*

Preschooler (3–6 years) greater than 75

School-age (6–12 years) greater than 80

Adolescent (12–18 years) greater than 90

*Note: In infants and children aged three years or younger, the
presence of a strong central pulse should be substituted for a
blood pressure reading.
 Pediatric CUPS Assessment
Category Assessment Actions Example
Critical Absent airway, Perform rapid initial Severe traumatic injury
breathing, or interventions and transport with respiratory arrest or
circulation simultaneously cardiac arrest

Unstable Compromised airway, Perform rapid initial Significant injury with

breathing, or interventions and transport respiratory distress,
circulation with simultaneously active bleeding, shock;
altered mental status near-drowning;
unresponsiveness

Potentially Normal airway, Perform initial assessment Minor fractures;

unstable breathing, circulation, with interventions; transport pedestrian struck by car
and mental status BUT promptly; do focused history but with good appearance
significant mechanism and physical exam during and normal initial
of injury or illness transport if time allows assessment; infant
younger than three
months with fever

Stable Normal airway, Perform initial assessment Small lacerations,

breathing, circulation, with interventions; do abrasions, or
and mental status; no focused history and detailed ecchymoses; infant older
significant mechanism physical exam; routine than three months with
of injury or illness transport fever
Based on CUPS Assessment Table © 1997 N. D. Sanddal, et al. Critical Trauma Care by the Basic EMT, 4th ed.
 Developmental Aspects of Pediatric Patients
Age* Keys to Successful Interaction Characteristics
Newborn Likes to be held and kept warm Normally alert, looking around
(birth to 1 May be soothed by having something to Focuses well on faces
month) suck on Flexed extremities
Avoid loud noises, bright lights

Infant Likes to be held Normally alert, looking around

(1–12 months) Parents should be nearby Eyes follow examiner
Examine from toes to head Slightly flexed extremities
Distract with a toy or penlight Can straighten arms and legs
Can sit unaided by 6–8 months

Toddler Make a game of assessment Normally alert, active

(1–3 years) Distract with a toy or penlight Can walk by 18 months
Examine from toes to head Does not like to sit still
Allow parents to participate in exam May grab at penlight or push
Respect modesty, keep child covered when hand away
possible

Preschooler Explain actions using simple language Normally alert, active

(3–6 years) Tell child what will happen next Can sit still on request
Tell child just before procedure if Can cooperate with examination
something will hurt Understands speech
Distract child with a story Will make up explanations for
Respect modesty anything not understood

School-age child Respect modesty Will cooperate if trust is

(6–12 years) Let child make treatment choices when established
possible Wants to participate and retain
Allow child to participate in exam some control

Adolescent Explain the process as to an adult Has clear concepts of future

(12–18 years) Treat the adolescent with respect Can make decisions about care
*Note that children who are frightened or in pain may act younger than their age