Tuesday, September 7, 2010

Peds Part I

I read a great blog (510 Medic) about the importance of taking vital signs in pediatric patients. The author cites great research on how often vital signs are not taken, especially blood pressure which puts our patients at risk if we are unable to properly assess and measure vital sign data. This issue cannot be underscored and is applicable to all providers in the emergency services - both pre-hospital and in the hospital. I often get asked about pediatric assessments (including vital signs) from nurses and paramedics alike. My answer is always the same...what does the child look like and do the vital signs match the rest of the clinical picture?

For instance, some years ago I had an ED nurse tell me that an infant had a respiratory rate of 8 - 10 and was in no distress. Apparently I had an alarmed look on my face as she questioned my concern. I asked, "what does the child look like - color, skin temp, capillary refill, respiratory effort, etc.?" She proceeded to tell me the child was comfortably sitting in the mother's lap, skin very warm, flushed cheeks, but taking Pediatlyte from a bottle. Obviously I reassessed the child including vital signs and found that the respiratory rate was in fact almost triple the original rate and the heart rate was quite tachycardic due to fever.

It is important that we synthesize all the patient data and evaluate what we are hearing or seeing. Does it make sense with the clinical picture?

Thanks to 510 Medic for addressing a topic near and dear to my heart! Stay tuned for Part II with a discussing breaking down the numbers and correlating to the pediatric assessment.


  1. it's just the usual in my mind: anyone can do any job, but the difference is how well one does it. and we know full well there are plenty who don't do whatever job it is they do properly.

  2. Couldn't agree more, so often I see children assessed through visualization and observations only, as if an spo2 reading and HR is simply enough to provide an accurate clinical picture, pretty absurd when you think about it....