🩺 Clinical Shortcut

Vital Signs Bedside Reference

Fast adult and pediatric vital signs reference for ward rounds, OPD, ER triage, and case presentation. Use values as a clinical screening guide, then interpret with the patient’s age, baseline, symptoms, medication, measurement method, and local hospital policy.

🌡️

Temperature

Normal adult oral temperature is approximately 36.5–37.2°C. Fever thresholds depend on route and context.

🫁

Respiratory Rate

Always count properly. RR is one of the most sensitive signs of deterioration.

🫀

Pulse + BP

Interpret HR and BP with pain, fever, anxiety, dehydration, shock, and medications.

Adult Vital Signs

Common resting adult reference values for bedside screening.

Parameter	Typical Adult Reference	Concerning Findings	Clinical Notes
Temperature	Oral approx. 36.5–37.2°C	Fever usually ≥38°C Hypothermia <35°C	Route matters: oral, axillary, tympanic, rectal, and temporal readings differ.
Heart Rate / Pulse	60–100 bpm at rest	Tachycardia >100 Bradycardia <60	Athletes may have lower resting HR. Check rhythm, volume, equality, and symptoms.
Respiratory Rate	12–20 breaths/min	RR <8 or >30 is high risk	Count for a full minute if abnormal. Do not tell the patient you are counting breathing if it changes their pattern.
Blood Pressure	Often around 90/60 to <120/80 mmHg for normal screening	SBP <90 Repeated high BP needs confirmation	Use correct cuff size, arm at heart level, patient rested. Diagnose hypertension using formal criteria, not one reading.
Oxygen Saturation	95–100% in most healthy adults on room air	≤90% emergency concern 91–94% abnormal in most patients	COPD and chronic hypoxemia may have individualized targets. Check waveform and perfusion.
Capillary Refill Time	Usually ≤2 seconds	Delayed CRT	Cold environment, peripheral vascular disease, and poor technique can affect CRT.
Pain Score	0–10 numeric scale if able to report	Severe pain 7–10	Pain can raise HR, BP, and RR. Use age-appropriate pain scales.
Conscious Level	Alert / normal baseline	New confusion, drowsiness, seizure, unresponsive	Use AVPU quickly, GCS when detailed neurological assessment is needed.

Pediatric Vital Signs by Age

Practical bedside ranges for children. Use the child’s appearance, trend, perfusion, and work of breathing before judging by numbers alone.

Age Group	Heart Rate	Respiratory Rate	Blood Pressure	Temperature / SpO₂	What to Check Clinically
Neonate Birth to 28 days	Awake 100–205 bpm Asleep 90–160 bpm Bradycardia is concerning if associated with apnea, cyanosis, poor tone, or poor perfusion. Crying, fever, pain, and hypoxia can increase HR.	30–60/min Look for grunting, nasal flaring, recession, apnea, cyanosis. Periodic breathing can occur, but apnea or color change is abnormal.	Term newborn SBP often roughly 60–90 mmHg, but depends on gestational age, birth weight, and postnatal age. Assess pulses, CRT, urine output, feeding, tone.	Temp approx. 36.5–37.5°C SpO₂ usually ≥95% after transition Temperature instability can be a sign of neonatal sepsis.	Feeding, activity, color, tone, hydration, fontanelle, respiratory effort, perfusion, and sepsis signs.
Infant 1 to 12 months	Awake 100–190 bpm Asleep 90–160 bpm Tachycardia may reflect fever, dehydration, pain, bronchiolitis, sepsis, or shock.	30–53/min Count before disturbing the infant when possible. Check feeding difficulty and pauses during feeds.	Approximate SBP screening range often 70–104 mmHg. Hypotension concern if SBP <70 mmHg. Formal BP interpretation needs age, sex, height percentile.	Fever usually ≥38°C SpO₂ usually 95–100% Fever in young infants needs careful assessment.	Poor feeding, reduced wet diapers, lethargy, irritability, sunken eyes/fontanelle, respiratory distress, CRT.
Toddler 1 to 2 years	Awake 98–140 bpm Asleep 80–120 bpm Repeat HR when calm if the child is crying and clinically stable.	22–37/min Observe for tracheal tug, intercostal/subcostal recession, wheeze, stridor.	Approximate SBP screening range often 86–106 mmHg. Hypotension concern: SBP <70 + 2 × age.	Fever usually ≥38°C SpO₂ usually 95–100% SpO₂ 91–94% is abnormal in most children; ≤90% is urgent.	General appearance, hydration, activity, respiratory effort, rash, neck stiffness, perfusion, urine output.
Preschool 3 to 5 years	Awake 80–120 bpm Asleep 65–100 bpm Persistent tachycardia after antipyretic/fluids is more concerning.	20–28/min High RR with fever may occur, but persistent tachypnea suggests respiratory/metabolic disease.	Formal BP requires percentile chart. Hypotension concern: SBP <70 + 2 × age. Use correct cuff size.	Fever usually ≥38°C SpO₂ usually 95–100% Low SpO₂ with distress needs escalation.	Work of breathing, hydration, mental status, abdominal tenderness, rash, pain score, response to treatment.
School-age 6 to 11 years	Awake 75–118 bpm Asleep 58–90 bpm Consider fever, anxiety, pain, dehydration, anemia, sepsis, asthma, medications.	18–25/min Do not estimate RR; count it properly.	Formal BP requires age, sex, and height percentile. Until age 10: hypotension concern SBP <70 + 2 × age. Age ≥10: concern if SBP <90 mmHg.	Fever usually ≥38°C SpO₂ usually 95–100% Check device signal if SpO₂ does not match appearance.	Perfusion, mental status, respiratory effort, hydration, urine output, pain, neurological signs, sepsis signs.
Adolescent 12 years and older	Awake 60–100 bpm Asleep 50–90 bpm Athletes may have lower resting HR if asymptomatic.	12–20/min High RR can indicate asthma, pneumonia, DKA, sepsis, anxiety, pain.	Adult-like screening often applies. Hypotension concern often SBP <90 mmHg. Repeated high BP requires proper confirmation.	Fever usually ≥38°C SpO₂ usually 95–100% Consider chronic disease baseline if known.	Adult-style ABCDE assessment plus medication/substance use, pregnancy possibility when relevant, mental status, pain.

⚠️ Pediatric BP safety note

Pediatric blood pressure is not accurately judged using one universal “normal” number. Formal interpretation in children requires age, sex, and height percentile. Use this page as a bedside screening guide only.

🚨 Pediatric shock warning

Children can maintain blood pressure until late shock. Do not wait for hypotension if there is tachycardia, poor perfusion, altered mental status, weak pulses, cold extremities, mottling, or delayed capillary refill.

How to Measure Vital Signs Correctly

Bad technique gives misleading numbers.

🌡️ Temperature

Document the route: oral, axillary, tympanic, rectal, temporal.
Axillary can read lower than core temperature.
Repeat if the value does not match clinical appearance.

🫀 Pulse / Heart Rate

Assess rate, rhythm, volume, and equality.
Count manually if irregular or if monitor reading seems wrong.
Check central pulse in unstable patients.

🫁 Respiratory Rate

Count for 30–60 seconds; use a full minute if abnormal.
Look for recession, nasal flaring, grunting, wheeze, stridor, cyanosis.
Respiratory rate is commonly missed or inaccurately estimated.

🩸 Blood Pressure

Cuff bladder width should be about 40% of arm circumference.
Cuff bladder length should cover about 80–100% of arm circumference.
Arm should be supported at heart level; repeat if abnormal.

🧪 Oxygen Saturation

Check waveform, pulse match, and signal quality.
Cold fingers, nail polish, movement, poor perfusion, and shock can affect readings.
Escalate if low saturation is associated with distress, cyanosis, confusion, or exhaustion.

⏱️ Trend

One normal reading does not exclude deterioration.
Compare with previous readings, baseline, fever curve, fluid balance, and treatment response.
Document time and context: asleep, crying, post-nebulization, post-antipyretic, on oxygen.

Vital Signs Red Flags

Numbers that should make you reassess immediately.

🚨 Immediate concern

Low SpO₂, cyanosis, apnea, exhaustion, or silent chest.
Altered consciousness, seizure, or new confusion.
Shock signs: weak pulse, cold extremities, delayed CRT, mottling, hypotension.
Severe tachycardia or bradycardia with poor perfusion.
High or low temperature in a toxic-looking patient.

⚠️ Recheck before trusting the value

Child crying or moving during measurement.
Wrong BP cuff size.
Poor pulse oximeter waveform.
Cold extremities or poor peripheral perfusion.
Monitor reading does not match manual assessment.

✅ Stable presentation phrase

“The patient is vitally stable, afebrile, not tachycardic, not tachypneic, maintaining oxygen saturation on room air, and has no clinical signs of shock.”

🚨 Unstable presentation phrase

“The patient is clinically unstable with abnormal vital signs, including tachycardia/tachypnea and signs of poor perfusion. Immediate senior review and reassessment are required.”

Quick Bedside Tools

Simple tools for teaching and quick checks. Not a replacement for hospital protocols.

🧮 Pediatric Hypotension Threshold

For ages 1–10 years: hypotension concern if systolic BP is below 70 + 2 × age in years.

Age in years

Enter age 1–10 years.

🫁 Oxygen Device Reminder

Choose oxygen support according to distress severity and local policy.

Room air SpO₂

Select a value.

Ward Presentation Structure

Use this when presenting vital signs during rounds or OPD.

1) Basic format

“On examination, the patient was alert and clinically stable. Temperature was __°C, heart rate __ bpm, respiratory rate __/min, blood pressure __/__, oxygen saturation __% on room air, and capillary refill was __ seconds.”

2) Pediatric respiratory case

“The child is tachypneic for age with increased work of breathing, including __. Oxygen saturation is __% on __. There are / are no signs of exhaustion or cyanosis.”

3) Dehydration case

“The patient has signs of dehydration with dry mucous membranes, reduced urine output, heart rate __ bpm, capillary refill __ seconds, and blood pressure __/__. There are / are no signs of shock.”

4) Fever case

“The patient is febrile at __°C with heart rate __ bpm and respiratory rate __/min. Perfusion is __, capillary refill is __ seconds, and there are / are no toxic features.”

Source & Safety Notes

Built for student bedside revision. Always follow your hospital’s pediatric early warning score, adult early warning score, PALS/APLS guidance, and senior instructions.

References used to build this page

PALS-style pediatric HR and RR ranges.
PedsCases pediatric vital signs reference chart.
Royal Children’s Hospital guidance on acceptable pediatric physiological ranges and clinical trends.
Johns Hopkins Medicine adult vital signs overview.
NCBI StatPearls vital sign assessment overview.

Important limitation

“Normal” values differ slightly between references. A value outside the range is not automatically a diagnosis, and a value inside the range does not guarantee the patient is safe. Always assess the full clinical picture.