What Is 'Normal?' Evaluating Vital Signs
What Is 'Normal?' Evaluating Vital Signs
Literature searches using keywords "vital signs," "blood pressure," "heart rate," "respiratory rate," "normal," "normative," "early warning," "deterioration," "pediatric," and "children" were run using the EBSCO, CINAHL, PubMed, and Scopus databases. Additionally, authors performed manual searches of references, guidelines, and textbooks. Articles and texts were excluded if they did not address children 1 to 5 years of age, or if they addressed a specific disease or illness process, such as cardiovascular disease or asthma. Eight textbooks and four review articles containing pediatric normative VS parameters were reviewed. The search revealed nine articles reporting research findings on one or more parameters. In addition, six articles about pediatric early warning parameters were also reviewed. Although literature on temperature and oxygen saturation was found, only those results pertaining to BP, pulse, and respiratory rates are reported here.
Evidence was then rated based on the system proposed by Melnyk and Fineout-Overholt (2011). In this rating system, Level I is the highest ranked and includes a systematic review or meta-analysis. Level II, consists of randomized controlled trials, while Level III lacks the randomization of the previous level. Case-control and cohort studies comprise Level IV, and a systematic review from descriptive studies is rated as Level V. Level VI is based on evidence from one descriptive or qualitative study. The lowest level of evidence is Level VII; which is classified as expert opinion from individuals or committees.
Methodology
Literature searches using keywords "vital signs," "blood pressure," "heart rate," "respiratory rate," "normal," "normative," "early warning," "deterioration," "pediatric," and "children" were run using the EBSCO, CINAHL, PubMed, and Scopus databases. Additionally, authors performed manual searches of references, guidelines, and textbooks. Articles and texts were excluded if they did not address children 1 to 5 years of age, or if they addressed a specific disease or illness process, such as cardiovascular disease or asthma. Eight textbooks and four review articles containing pediatric normative VS parameters were reviewed. The search revealed nine articles reporting research findings on one or more parameters. In addition, six articles about pediatric early warning parameters were also reviewed. Although literature on temperature and oxygen saturation was found, only those results pertaining to BP, pulse, and respiratory rates are reported here.
Evidence was then rated based on the system proposed by Melnyk and Fineout-Overholt (2011). In this rating system, Level I is the highest ranked and includes a systematic review or meta-analysis. Level II, consists of randomized controlled trials, while Level III lacks the randomization of the previous level. Case-control and cohort studies comprise Level IV, and a systematic review from descriptive studies is rated as Level V. Level VI is based on evidence from one descriptive or qualitative study. The lowest level of evidence is Level VII; which is classified as expert opinion from individuals or committees.