A5V4d

Clinical assessment of the child with fever
commonly used scale in the UK, was simple to apply and closely matched the cut-offs used in the
Craig study, which had shown an association between tachycardia and serious illness.
Table 5.63 Normal ranges of heart rate according to Advanced Paediatric Life Support (APLS) and Pediatric
Advanced Life Support (PALS)
Age range (years) APLS PALS
Neonate 110 – 160 85 – 205
0 – 1 110 – 160 100 – 190
1 – 2 100 – 150 100 – 190
2 – 3 95 – 140 60 – 140
3 – 5 95 – 140 60 – 140
5 – 6 80 – 120 60 – 140
APLS Advanced Paediatric Life Support, PALS Pediatric Advanced Life Support
Source: Fleming et al, 2011, Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a
systematic review of observational studies, The Lancet 2011; 377: 1011–18
However, the GDG also highlighted the findings of a systematic review of normal heart rates in
children (Fleming et al., 2011). This review contained data on heart rate in children from 59 studies
that included 143,346 children (see Table 5.64).
Table 5.64 Normal ranges of heart rate according to the Fleming study
Age range 10th centile 25th centile Median 75th centile 90th centile
Birth 107 116 127 138 148
0 – 3 months 123 133 143 154 164
12 – 18 months 103 112 123 132 140
18 – 24 months 98 106 116 126 135
2 – 3 years 92 100 110 119 128
3 – 4 years 86 94 104 113 123
4 – 6 years 81 89 98 108 117
(Fleming et al, 2011, Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic
review of observational studies, The Lancet 2011; 377: 1011–18)
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2013 Update