From the Guidelines
Normal vital signs for a pediatric patient with new onset abdominal pain vary by age, and it is crucial to recognize these ranges to identify potential serious conditions early. For infants (0-12 months), heart rate typically ranges from 100-160 beats per minute, respiratory rate 30-60 breaths per minute, and blood pressure around 65-90/45-65 mmHg. For toddlers (1-3 years), heart rate is usually 90-150 beats per minute, respiratory rate 24-40 breaths per minute, and blood pressure approximately 80-100/50-70 mmHg. School-age children (4-12 years) typically have heart rates of 70-120 beats per minute, respiratory rates of 18-30 breaths per minute, and blood pressure around 90-110/55-75 mmHg. Adolescents (13-18 years) generally have heart rates of 60-100 beats per minute, respiratory rates of 12-20 breaths per minute, and blood pressure approximately 100-120/60-80 mmHg. Normal temperature across all age groups is 36.5-37.5°C (97.7-99.5°F) 1.
Key points to consider when evaluating vital signs in pediatric patients with abdominal pain include:
- Recognizing age-specific normal ranges for heart rate, respiratory rate, and blood pressure
- Identifying significant deviations from these normal ranges, such as tachycardia, tachypnea, hypotension, or fever
- Understanding that these vital signs serve as important baseline measurements to assess the severity of the condition and monitor for deterioration 1.
Given the potential for serious conditions like appendicitis, as discussed in the context of acute abdominal pain in children 1, it is essential to closely monitor vital signs and promptly investigate any abnormalities to ensure timely intervention and prevent complications.
From the Research
Normal Vital Signs for Pediatric Patients with New Onset Abdominal Pain
The normal vital signs for pediatric patients can vary based on age, but generally include:
- Heart rate: 80-160 beats per minute for infants, 70-120 beats per minute for children [@\1@, @\4@]
- Respiratory rate: 20-40 breaths per minute for infants, 16-30 breaths per minute for children
- Blood pressure: 80-100 mmHg systolic, 50-70 mmHg diastolic for infants, 90-120 mmHg systolic, 50-80 mmHg diastolic for children
- Oxygen saturation: greater than 95% on room air
- Temperature: 98.6-100.4°F (37-38°C)
Assessment of Abdominal Pain in Pediatric Patients
When assessing abdominal pain in pediatric patients, it is essential to consider the patient's age, medical history, and physical examination findings [@\3@, @\5@]. The physical examination should include:
- Abdominal palpation to assess for tenderness, guarding, or rebound tenderness
- Assessment of bowel sounds
- Evaluation for signs of peritonitis, such as rigidity or involuntary guarding
- Assessment of the patient's overall appearance and behavior, including signs of distress or discomfort
Laboratory and Imaging Studies
Laboratory and imaging studies may be ordered to help diagnose the cause of abdominal pain in pediatric patients [@\4@, @\5@]. These may include:
- Complete blood count (CBC)
- Urinalysis
- Human chorionic gonadotropin (hCG) level
- Lactate and C-reactive protein (CRP) levels
- Comprehensive metabolic profile (CMP)
- Ultrasonography, including point-of-care ultrasonography
- Validated scoring systems, such as the Pediatric Appendicitis Score, to help determine the patient's risk of appendicitis [@\4@]