Pediatric vital signs

[2bnurse2011]

We have been given some lab paperwork & there is a question that I cannot find the answer:

When assessing a child, in what order should you obtain vital signs? Please provide rationale.

I have searched our textbook, my lab manual, & the internet & can't seem to find any info. I didn't even know there was an order for vitals.

Any help would be appreciated!

[ittybabyRN, RN]

Well, I know when assessing infants I would do rr/hr first before the baby has the chance to wake up and become upset, then blood pressure, temp last because no baby likes having their temp taken and that's when they usually start screaming...least invasive to most invasive with babies/kids

[NotReady4PrimeTime, RN]

I'll take a wild guess, based on 16 years of experience and not on any list I've ever seen... count resps first (watch their tummy because it moves more than their chest), because the second you touch that kid they're going to hike up their breathing. Then count HR (which will have hiked a bit too, but it usually settles back to baseline fairly quickly), get their temp and then their BP if needed. Most times BPs aren't accurate anyway because they tense up and/or start crying and squirming when the cuff inflates.

[LiveZen]

I second the OP:

RR first (while they're sleeping or just "checking you out"...gives them a minute to adjust to a new person in the room)

HR next (while they're still calm)

BP next (because they're usually ticked after their temperature and less likely to hold still)

Temp last (especially if it's going to be a rectal temp)

With older/cooperative kids, I don't think it matters as much the specific order, but you want your numbers to be accurate, so you want them as calm as possible.

Remember that kids are usually much more cooperative if they can look at/touch/play with (if appropriate) your "tools" first...let them strap a BP cuff on their leg, or show them how to feel their pulse in their wrist.