b. Blood Pressure.
(1) Younger children generally have lower blood pressures, higher pulses,
and higher respiratory rates than adults.
(2) A child's blood pressure should be checked with the correctly-sized cuff.
The proper size is about two-thirds of the circumference of the child's upper arm.
Younger children generally have higher respiratory rates than adults.
(2) A child or infant's respirations can be checked by placing your hand on
his stomach. Take the respiration rate frequently. An increase in the respiration rate
may be significant.
(1) An early warning sign of shock in a child may be tachycardia
(abnormally fast heart beat).
(2) Prolonged capillary refill is another early warning sign of shock in a child.
To check capillary refill, use the blanch test. Press on the child's nail bed until you
exert enough pressure to cause the area under the nail to show white. To be
considered normal, the color in that area should return by the time you repeat the words
"capillary refill." That time is approximately two seconds.
e. Heart Beat/Heart Rate.
(1) Bradycardia (abnormally slow heart beat), a worrisome sign in children,
may be caused by pressure in the child's skull, depressant drugs, or some
comparatively rare medical condition.
(2) A child's heart rate is somewhat higher than the heart rate of an adult. A
child's heart rate is heard more centrally in his chest than the adult's heart rate.
Therefore, take a child's heart rate by placing the stethoscope below the scapula on the
left side of the child's back.
(1) In infants and toddlers, the carotid pulse is very difficult to feel because
the neck of an infant or a toddler is short. The most reliable pulse to check is the apical
pulse. (The apial pulse is taken by placing the stethoscope near the apex of the