Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Values suggesting physiological failure
Severe hypoxaemia, bradypnoea, bradycardia, hypotension or falling consciousness is late deterioration and needs ABCDE rather than repeated routine observation.
Action: Call paediatric emergency help and begin ABCDE. Verify an unexpected reading rapidly with correct probe, cuff and manual assessment, but do not delay oxygenation, ventilation or circulatory support when the child looks unwell. Compare with the current RCUK age table and the child's known baseline, repeat after each intervention and escalate for a concerning trend even before a single value crosses a threshold.
Synopsis
Measure paediatric observations accurately, compare them with current age-specific reference limits and interpret state, baseline and trend without missing compensated deterioration.
Measure before interpreting: observe a settled child, count respiratory rate for a full minute in infants and use a correctly sized blood-pressure cuff and reliable saturation waveform.
RCUK 2025 approximate respiratory-rate ranges are 25–60/min at 1 month, 20–50 at 1 year, 18–40 at 2 years, 17–30 at 5 years, 14–25 at 10 years and 12–20 at 18 years.
RCUK 2025 approximate heart-rate ranges are 110–180/min at 1 month, 100–170 at 1 year, 90–160 at 2 years, 70–140 at 5 years, 60–120 at 10 years and 60–100 at 18 years.
Key red flags
A falling respiratory rate with reduced effort, poor air entry or drowsiness indicates exhaustion rather than recovery.
Investigation priorities
01
First-line: respiratory rate and effortFirst stepFirst line
Detect early respiratory or metabolic stress and later fatigue.
02
First-line: pulse and perfusionFirst line
Assess cardiovascular compensation and possible arrhythmia.
Management branches
Routine observationsMeasure under known conditions
A child requires a baseline or repeat observation set.
Settle and observe the child, select age-appropriate probe and cuff and record oxygen and behavioural state.
Measure respiratory rate, pulse, saturation, temperature, perfusion and indicated blood pressure and consciousness accurately.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.