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Paediatric vital signs

Vital signs such as temperature, heart or pulse rate, respiratory rate and effort, blood pressure, pain assessment and level of consciousness are all taken into account by doctors, nurses and other health professionals working with infants, children and young people.

Usually, a systematic process is used when assessing, measuring and recording vital signs. They include visual observation, palpation (touch), listening and communication.

There are also certain protocols and procedures, specific to infants, children and young people for monitoring vital signs, for example after an operation, during blood transfusions and other therapies or in an emergency.

Assessing vital signs in a casualty situation

Take no more than 10 seconds to look for signs of any movement, coughing or normal breathing (not just infrequent, gasping breaths). Tilt the head backwards and look and feel for breaths.

Call an ambulance if a child:

  • Stops breathing
  • Is struggling for breath (for example, you may notice sucking in under the ribcage)
  • Is unconscious or seems unaware of what's going on
  • Won’t wake up
  • Has a fit for the first time, even if they seem to recover

Dr ABC

The priorities when dealing with any casualty can be remembered as Dr ABC:

  • Danger
  • Response
  • Airway
  • Breathing
  • Circulation

Danger

Always make sure there is no danger to yourself before you approach the scene. You are no help to an injured person if you become a second casualty, for example by running into the path of approaching traffic after a road accident. If appropriate, take steps to safeguard the casualty from further injury and to make sure others are not endangered, for example by warning other drivers that there is an incident ahead.

Response

  • Are they alert?
  • Do they respond to voice?
  • Do they respond to pain, such as rubbing a knuckle briskly over the breastbone?
  • Is there no response to any stimulus (unconscious)?

Airway

If there is no response, leave the child in the position they are in and open their airway. If this is not possible in the position they are in, gently lay them on their back and open the airway.

You open the airway by placing one hand on the child’s forehead and gently tilting the head back, then lifting the chin using two fingers. This is to move the tongue away from the back of the mouth.

If you think they may have a spinal injury, place your hands on either side of their face and use your fingertips to gently lift the jaw to open the airway. Take care not to move the child’s neck. This is known as the jaw thrust technique.

Breathing

To check if the child is still breathing, look to see if their chest is rising and falling, listen for breathing and check if you can feel their breath against your cheek for 10 seconds.

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