Assessments (Paediatric)
 
Perfusion (Paediatric)
Editor's Note: You may also want to see the PSA Table that I complied.
a) Adequate Perfusion:
Age
Pulse
Blood Pressure
Newborn
120-160
N/A
Infant
100-160
>70 mmHg systolic
Small Child
80-120
>80 mmHg systolic
Large Child
80-100
>90 mmHg systolic
Skin - warm, pink, dry.
Conscious, alert, active.
 
b) Inadequate Perfusion:
Age
Pulse
Blood Pressure
Newborn
<100/min or >170
N/A
Infant
<90/min or >170
<60 mmHg systolic
Small Child
<75/min or >130
<70 mmHg systolic
Large Child
<65/min or >100
<80 mmHg systolic
Skin - warm, pink, dry.
Conscious, alert, active.
 
c) No Perfusion:
Absence of palpable pulses.
Skin - cool, pale.
Unrecordable blood pressure.
Unconscious
 
Respiratory Status Assessment
Editor's Note: You may also want to see the RSA Table that I complied.
Normal Respiratory Rates
Newborn 40-60 breaths/min
Infant 20-50 breaths/min
Small Child 20-35 breaths/min
Large Child 15-25 breaths/min
Criteria
a) Signs of respiratory distress include:
Tachypnoea
Use of accessory muscles
Grunting
Pallor
Wheezing
Abdominal protrusion
Chest wall retraction
Cyanosis (late sign)

b) Signs of hypoxia include:
Infants
Children
Lethargy
Restlessness
Bradycardia
Tachypnoea
Hypotension
Tachycardia
Apnoea
Cyanosis
Pallor
 Bradycardia (late sign) 

c) Carbon dioxide retention manifestation is manifested by:
- Sweating (uncommon in infants).
- Tachycardia.
- Bounding pulse.
- Hypertension.
. Pupillary dilatation.
- Eventually leading to cardiovascular and central nervous system depression.

Respiratory failure is common in the first two years of life. Small caliber airways are prone to obstruction. Respiratory distress may reflect disorder of other body systems - cardiac failure, abdominal distension, neurological problems.
 
Conscious State Assessment (Glasgow Coma Scale)
 
Child 4 years or less
Child over 4 years
Eye Opening
Eye Opening
Spontaneously
4
Spontaneously
4
React to speech
3
To voice
3
Reacts to pain
2
To pain
2
No response
1
No response
1
Best Verbal Response
Best Verbal Response
Appropriate words or social smile, fixes, follows
5
Orientated
5
Cries but consolable
4
Confused
4
Persistently irritable
3
Inappropriate words
3
Restless and agitated
2
Incomprehensible sounds
2
No response
1
No response
1
Best Motor Response
Best Motor Response
Spontaneous
6
Obeys command
6
Spontaneous Localises to pain
5
Localises to pain
5
Withdraws from pain
4
Withdraws from pain
4
Flexion response
3
Flexion response
3
Extension response
2
Extension response
2
No response
1
No response
1
Total
 
Total
 
 
APGAR Scoring System
The APGAR score should be conducted 1 minute after delivery and repeated at 5 minutes after delivery.

A score of:
7-10 Satisfactory
4-6 Moderate depression and may need respiratory support
0-3 Newborn requiring resuscitation

Points
0
1
2
Appearance
Blue, Pale
Body pink
Extremities blue
Totally pink
Pulse
Absent
<100
>100
Grimace
None
Grimaces
Cries
Activity
Limp
Flexion of Extremities
Active motion
Respiratory Effort
Absent
Slow and weak
Good strong cry