Pediatric vitals signs

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Heart Rate/Pulse

 

The newborn heart rate is about 140 beats per minute, and gradually decreases to adult values at about age 14. Abnormal pediatric rhythms are rare. Sinus tachycardia is often seen in dehydration and/or infection (i.e., sepsis).

Supraventricular tachycardia is the more common of the rare arrhythmias in pediatrics. As in the adult, it is usually caused by a re-entry mechanism. The rate in infants is usually greater than 220 beats per minute, and in children greater than 180.

Treatment: In the stable patient, vagal maneuvers are attempted and adenosine (Adenocard) 0.1 mg/kg is administered as a bolus. If this is not effective, a second dose is administered at 0.2 mg/kg. In the unstable patient or if adenosine is ineffective, synchronized cardioversion is performed at 0.5 joules/kg.

Bradyarrhythmias in children are usually the result of hypoxemia and/ or acidosis, and treatment is directed at correcting the underlying cause. Unstable patients may require epinephrine 0.01 mg/kg (1:10,000) every five minutes. Atropine 0.02 mg/kg is administered if the response to epinephrine is poor after two doses. Cardiac pacing may be required.