Overview
This lecture demonstrates the correct procedure for assessing vital signs and growth measurements in infants, emphasizing order, technique, and normal ranges.
Sequence of Infant Vital Sign Assessment
- Start with the most non-invasive measurements while the infant is calm: respirations, heart rate, temperature, weight, length, head circumference, and chest circumference.
- Gather all supplies beforehand: infant stethoscope, measuring tape, thermometer, scale, and a watch.
- Sanitize all equipment and perform hand hygiene before and after the assessment.
Respiratory Assessment
- Count respirations first while the infant is calm, for a full one minute.
- Normal infant respiratory rate is 30–60 breaths per minute.
- Watch for signs of respiratory distress: nasal flaring, chest retractions, and cyanosis (bluish skin color).
- Infants may have irregular ("periodic") breathing patterns; always count for a full minute.
Heart Rate Assessment
- Use an infant-sized stethoscope to assess the apical pulse, not the radial pulse.
- For infants <1 month: normal heart rate is 100–190 bpm; for >1 month: 90–180 bpm.
- Locate the apical pulse at the fourth intercostal space, lateral to the midclavicular line.
- Heart rhythm may be irregular (sinus arrhythmia); count for a full minute.
Temperature Measurement
- Take temperature via the axillary (armpit) route.
- Normal axillary temperature range in infants: 97.5–99.3°F (36.4–37.4°C).
- Place the thermometer tip deep in the armpit, lower the arm, and record the reading once it beeps.
Infant Weight Measurement
- Remove clothing and any soiled diaper for accurate measurement; a dry diaper may be used.
- Place the infant on the scale and document the weight in pounds and ounces.
- Compare with birth weight to assess growth.
Length, Head, and Chest Circumference Measurement
- Measure length from head to heel with the infant lying flat, head midline, and leg extended; normal length is 18–22 inches.
- Measure head circumference above eyebrows and around the largest part at the back; normal is 33–38 centimeters.
- Measure chest circumference at the nipple line; it should be 1–2 cm less than head circumference.
Key Terms & Definitions
- Respiratory Distress — difficulty breathing indicated by nasal flaring, chest retractions, or cyanosis.
- Periodic Breathing — irregular breathing pattern seen in infants.
- Apical Pulse — heartbeat heard at the chest over the heart's apex, used for accurate heart rate in infants.
- Sinus Arrhythmia — normal variability in heart rate with breathing.
- Cyanosis — bluish discoloration of the skin due to low oxygen.
Action Items / Next Steps
- Review other videos in the Pediatrics series for more infant assessment skills.
- Practice proper hand hygiene and equipment sanitation before and after assessments.