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NORMAL VALUES FOR VITAL SIGNS

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Two standard tables are shown for comparison.

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Vital signs (average)

< 6 months

6 months–3 years

3–12 years

Adult

Pulse (beats/min)

120–140

110

80–100

60–100

Respiration rate (breaths/min)

45

30

20

14

BP (mmHg)

90/60

90/60

100/70

≤ 130/85

Source: From J. Murtagh, General Practice Companion Handbook, 2011, p. xxxv

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Table Graphic Jump Location
Table 17.1

Paediatric vital signs: American College of Surgeons

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PULSE OXIMETRY

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The pulse oximeter measures oxygen saturation of arterial blood (SpO2).

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Facts and figures
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In a healthy young person the O2 saturation should be 95–99%. It varies with age, the degree of fitness, current altitude and oxygen therapy. Studies show that white race, obesity and male sex but not smoking are associated with lower SpO2 readings.1

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The ideal value is 97–100%.

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The median value in neonates is 97%, in young children 98% and adults 98%.

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Target oxygen saturation
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  • Asthma—the aim is to maintain it > 94%

  • Acute coronary syndromes ≥ 94%

  • Opioid effect ≥ 94%

  • Type 1 (hypoxemic) respiratory failure (e.g. interstitial lung disease, pneumonia, pulmonary oedema) ≥ 94%

  • Severe COPD with hypercapnoeic respiratory failure 88–92%

  • Critical illness (e.g. major trauma, shock) 94–98%

  • Children > 94% (< 94% is a concern)

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Indications for oxygen therapy to be beneficial
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  • Australian guideline to improve quality of life > 88%

  • UK: adults < 50 years 90%, asthma 92.3%

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Availability and cost
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Pulse oximeters are readily available from medical and surgical suppliers with a range in cost from about $40 to $3000. A good-quality unit is available for about $400.

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ACUTE CORONARY SYNDROMES

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In the author’s rural practice, over a period of 10 years, the most common cause of sudden death was myocardial infarction, which was responsible for 67% of deaths in the emergency situation. The importance of confirming early diagnosis with the use of the electrocardiogram and serum markers, especially troponin, is obvious. A summary of acute coronary syndromes is presented in Table 17.2.

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Table Graphic Jump Location
Table 17.2

Types of acute coronary syndromes

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