- Rectal: Most accurate core temperature - "Gold standard" method
- Oral (sublingual): Convenient and reliable - posterior sublingual pocket most accurate
- Tympanic (ear): Quick but affected by earwax, positioning, and technique
- Axillary (armpit): Convenient but least accurate - generally 1°F lower than oral
- Temporal (forehead): Non-invasive, good for pediatrics but variable accuracy
- Digital/Electronic: Most commonly used, follow manufacturer instructions
📊 Vital Signs Reference Guide
Essential age-specific ranges, critical values, and nursing considerations for safe, effective patient care and clinical decision-making.
🩺 What Are Vital Signs?
Vital signs are measurable indicators of the body's basic physiological functions and overall health status. They are routinely assessed to detect acute changes, guide interventions, and monitor treatment response. Healthcare professionals use vital signs as the first step in assessing a patient's condition.
📋 The Six Vital Signs: The traditional five vital signs (temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation) are supplemented by pain assessment, often referred to as the "6th vital sign," reflecting the importance of pain management in patient care.
🌡️
Temperature
Body heat regulation
💓
Heart Rate
Cardiac function
🫁
Respiratory Rate
Breathing pattern
⚡
Blood Pressure
Circulatory force
🫀
Oxygen Saturation
O₂ in blood
😣
Pain Level
6th vital sign
👶🧒👩🦳 Age-Based Normal Ranges
Note: Ranges may vary slightly by institution. Always consider the patient's baseline and clinical context.
| Age Group | HR (bpm) | RR (breaths/min) | BP (mmHg) | Temp (°F) | SpO₂ (%) |
|---|---|---|---|---|---|
| Newborn (Term) | 120–170 | 25–60 | 60–95 / No specific range | 97.7–99.5 | ≥ 95% |
| 3 months | 115–170 | 25–60 | 60–105 / No specific range | 97.8–99.1 | ≥ 95% |
| 6 months | 110–170 | 20–55 | 75–105 / No specific range | 97.8–99.1 | ≥ 95% |
| 1 year | 105–150 | 20–45 | 70–105 / No specific range | 97.8–99.1 | ≥ 95% |
| 2 years | 95–150 | 20–40 | 70–105 / No specific range | 97.8–99.1 | ≥ 95% |
| 4 years | 80–150 | 17–30 | 75–110 / No specific range | 97.8–99.1 | ≥ 95% |
| 6 years | 75–140 | 16–30 | 80–115 / No specific range | 97.8–99.1 | ≥ 95% |
| 10 years | 60–130 | 15–25 | 85–120 / No specific range | 97.8–99.1 | ≥ 95% |
| 14 years | 60–115 | 14–25 | 90–125 / No specific range | 97.8–99.1 | ≥ 95% |
| Adult (18+ yr) | 60–100 | 12–18 | 90/60 – 120/80 | 97.8–99.1 | 95–100% |
| Older Adult (65+ yr) | 60–100 | 12–18 | <130/80 (target) | Variable (lower) | 95–100% |
💡 Pediatric Pattern: Heart rate and respiratory rate generally decrease with age as children develop. Blood pressure increases with age and size.
🚨 Critical Values Requiring Immediate Action
TEMP
Hyperpyrexia: >104°F (40°C) — Risk of seizures, brain damage
Hypothermia: <95°F (35°C) — Metabolic dysfunction, cardiac arrhythmias
Hypothermia: <95°F (35°C) — Metabolic dysfunction, cardiac arrhythmias
HR
Bradycardia: <50 bpm in adults — Risk of decreased cardiac output
Tachycardia: >130 bpm in adults — Cardiac strain, possible shock
Tachycardia: >130 bpm in adults — Cardiac strain, possible shock
RR
Bradypnea: <10 breaths/min — Respiratory depression
Tachypnea: >30 breaths/min — Respiratory distress, metabolic issues
Tachypnea: >30 breaths/min — Respiratory distress, metabolic issues
BP
Hypotension: Systolic <90 mmHg — Organ perfusion compromise
Hypertensive Crisis: >180/120 mmHg — End-organ damage risk
Hypertensive Crisis: >180/120 mmHg — End-organ damage risk
SpO₂
Hypoxemia: <90% (especially with symptoms) — Tissue hypoxia
Severe: <85% — Immediate oxygen therapy required
Severe: <85% — Immediate oxygen therapy required
Body Temperature Assessment
▶
Normal Adult
98.6°F (37°C)
Normal Range
97.8–99.1°F
Fever Threshold
100.4°F (38°C)
Most Accurate Site
Rectal
Heart Rate & Pulse Assessment
▶
Adult Normal
60–100 bpm
Athletic
40–60 bpm
Assessment Duration
15–60 seconds
Best Site
Radial pulse
Blood Pressure Assessment
▶
Normal Adult
<120/<80 mmHg
Elevated
120-129/<80
High Stage 1
130-139/80-89
High Stage 2
≥140/≥90
Respiratory Rate Assessment
▶
Adult Normal
12–20 breaths/min
Assessment Time
Full 60 seconds
Observation
Chest rise/fall
Best Practice
Patient unaware
Oxygen Saturation (SpO₂)
▶
Normal Range
95–100%
Mild Hypoxemia
91–94%
Moderate
86–90%
Severe
<85%
😣
Pain Assessment (6th Vital Sign)
💡 Nursing Assessment Best Practices
Baseline Establishment
Always compare current readings to patient's baseline when available. A BP of 100/60 might be normal for one patient but concerning for another.
Environmental Factors
Ensure comfortable temperature, quiet environment, and appropriate patient positioning. Allow rest time before assessment.
Equipment Considerations
Use appropriately sized cuffs, calibrated equipment, and follow manufacturer guidelines for maintenance and cleaning.
Clinical Context
Consider medications, medical history, recent procedures, and pain levels when interpreting vital signs.
Trending Patterns
Single abnormal readings may be artifacts. Look for trends over time and correlation with clinical symptoms.
Prompt Communication
Report significant changes promptly to providers. Don't wait for the "perfect" time if values are critical.
🧠 Memory Aids & Quick References
Adult Vital Signs
"60-100, 12-20, <120/<80"
Quick recall for adult HR, RR, and BP normals.
Complete Assessment
"T-H-R-B-O-P"
Temperature, Heart rate, Respiratory rate, Blood pressure, Oxygen saturation, Pain.
Pediatric Pattern
"Kids Slow Down"
Heart rate and respiratory rate decrease as children age.
Critical Temps
"Under 95, Over 104"
Hypothermia <95°F, Hyperpyrexia >104°F require immediate action.
📚 References (APA 7th Edition) ▼
Click to view 13 sources cited
⚠️ Important Disclaimer
Educational Use Only: This reference guide is for educational purposes only and should not replace clinical judgment, institutional protocols, or provider orders. Normal ranges may vary by institution and patient population. Always follow your facility's policies and consult with healthcare providers for patient-specific care decisions.