Normal Vital Signs Guidelines for EMSCompiled using
Emergency Care and Transportation of the Sick and Injured,
EMS Field Guide and
Journal of Emergency Medical Services.
You will find it extremely valuable in the field (and for your national registry exam) to memorize these vital signs guidelines. To help you memorize them, I have organized them by type and by age group. You can decide which will be easier to remember.
Vital signs by type
Pulse
Descriptors: regular, irregular, strong or weak
Adult
60 to 100 beats per minute
Children - age 1 to 8 years
80 to 100
Infants - age 1 to 12 months
100 to 120
Neonates - age 1 to 28 days
120 to 160
Blood pressure
Systolic
Diastolic
Adult
90 to 140 mmHg
60 to 90 mmHg
Children - age 1 to 8 years
80 to 110 mmHg
Infants - age 1 to 12 months
70 to 95 mmHg
Neonates - age 1 to 28 days
>60 mmHg
Respirations
Descriptors: normal, shallow, labored, noisy, Kussmaul
Adult (normal)
12 to 20 breaths per minute
Children - age 1 to 8 years
15 to 30
Infants - age 1 to 12 months
25 to 50
Neonates - age 1 to 28 days
40 to 60
Vital signs by age
Adult vital signs
Pulse
60 to 100 beats per minute
Blood pressure
90 to 140 mmHg (systolic)60 to 90 mmHg (diastolic)
Respirations
12 to 20 breaths per minute
Child vital signs (age 1 to 8 years)
Pulse
80 to 100 beats per minute
Blood pressure
80 to 110 mmHg systolic
Respirations
15 to 30 breaths per minute
Infant vital signs (age 1 to 12 months)
Pulse
100 to 140 beats per minute
Blood pressure
70 to 95 mmHg systolic
Respirations
25 to 50 breaths per minute
Neonatal vital signs (full-term, <28 days)
Pulse
120 to 160 beats per minute
Blood pressure
>60 mmHg systolic
Respirations
40 to 60 breaths per minute
Other references
Lung sounds
Crackles or rales
crackling or rattling sounds
Wheezing
high-pitched whistling expirations
Stridor
harsh, high-pitched inspirations
Rhonchi
coarse, gravelly sounds
Pulse oximetry
Range
Value
Treatment
Normal
95 to 100%
None or placebic
Mild hypoxia
91 to 94%
Give oxygen
Moderate hypoxia
86 to 90%
Give 100% oxygen
Severe hypoxia
<85%
Give 100% oxygen w/ positive pressure
Glasgow Coma Scale
ADULT
INFANT
Eye opening
E
Eye opening
Spontaneous
4
Spontaneous
To speech
3
To speech
To pain
2
To pain
No response
1
No response
Best motor response
M
Best motor response
Obeys verbal command
6
Normal movements
Localizes pain
5
Localizes pain
Flexion - withdraws from pain
4
Withdraws from pain
Flexion - abnormal
3
Flexion - abnormal
Extension
2
Extension
No response
1
No response
Best verbal response
V
Best verbal response
Oriented and converses
5
Coos, babbles
Disoriented and converses
4
Cries but consolable
Inappropriate words
3
Persistently irritable
Incomprehensible sounds
2
Grunts to pain/restless
No response
1
No response
E + M + V = 3 to 15
90% less than or equal to 8 are in coma
Greater than or equal to 9 not in coma
8 is the critical score
Less than or equal to 8 at 6 hours - 50% die
9-11 = moderate severity
Greater than or equal to 12 = minor injury
Coma is defined as not opening eyes, not obeying commands, and not uttering understandable words.
Additional references: Traumatic Brain Injury Resource Guide and House of DeFrance.
Apgar Scale (evaluate @ 1 and 5 minutes postpartum)
Sign
2
1
0
A
Activity (muscle tone)
Active
Arms and legs flexed
Absent
P
Pulse
>100 bpm
<100 bpm
Absent
G
Grimace (reflex irritability)
Sneezes, coughs, pulls away
Grimaces
No response
A
Appearance (skin color)
Normal over entire body
Normal except extremities
Cyanotic or pale all over
R
Respirations
Good, crying
Slow, irregular
Absent
Pain scale
The 0-10 pain scale is becoming known as the "fifth vital sign" in hospital and pre-hospital care. Adults can usually quantify their pain on a numeric scale, however children may need help in articulating their pain.
The International Association for the Study of Pain has developed
