EMT-b student with another dumb question

[EMTalex]

Hey guys

I'm new to the forum as well as the country and EMS. This may sound like a stupid question but what is the national reg. pulse rate guide lines?

My textbook says : Adult 60-80, Adolescent 60-105, Child (5-12) 60-120, Child (1-5) 80-150, Infant (120-150)

Just wondering if it was any different.

 

[ResTech]

Textbook range for adult heart rate is 60-100. Which is what is also used to define bradycardia and tachycardia. Below 60 obviously bradycardia and above 100 would be tacycardia.

Different textbooks may quote slightly different rates for neonates, infants and children. Those rates you quote seem odd. Close ranges but odd.

 

[EMTalex]

yeah it did sound a bit off. cheers mate

 

[MMiz]

Which textbook are you referring to? The three I have don't list those values.

 

[EMTalex]

ummmm.....Prehospital Emergy Care 7th edition. by Mistovich

 

[gradygirl]

Definitely not a dumb question. Lots of authors have lots of differing opinions.

My EMT book (AAOS Emergency 9th ed.) said that pulse rates are:
Adults 60-120
Children 70-150
Infants 100-160

A little cheat card we were given (that was based off of PALS) said that pulse rates are:
Neborn-3 months 85-205
3 months-2 years 100-190
2 years-10 years 60-140
>10 years 60-100

Another card I've been given listed even different pulse rates. Ask any provider and they'll probably give you different answers...

 

[EMTalex]

oh, i see. Thanks for the advice mate. ^_^

On the National Registry test what is the answer though?

 

[Guardian]

the values you have are fine and they are guidelines anyway. A pulse rate of 40 might be fine in one person and severe bradycardia in another. For you nremt test, they wont ask you whether 59 is brady or 101 is tachy, the questions will be obvious.

 

[EMTalex]

Oh. Cheers mate

 

[Guardian]

Yea, I'm a nationally registered paramedic and i couldn't even tell you the exact figures nremt uses.

 

[EMTalex]

lol. thats funny. does it very from state to state or is there just an average median?

 

[MMiz]

lol. thats funny. does it very from state to state or is there just an average median?

I think you're missing the big picture. This is one of those things in EMS that isn't black and white. That AHA will disagree with the ARC, and you'll find books vary with their numbers. Generally no treatment you dispense will be based solely on one number, so if you're looking for any magic numbers in EMS I'm afraid you won't find any.

When you have your first marathon runner with a pulse in the low 40s, or maybe even the 30s, then it'll all make sense. You really have to look at the big picture.

 

[EMTalex]

so there's just a wide spectrum depending on the book and location you live. I guess i can live with that.

 

[fm_emt]

Google for "DOT EMT-B curriculum" - that's what the NR seems to go off of. It's also a great study guide.

 

[Jon]

so there's just a wide spectrum depending on the book and location you live. I guess i can live with that.

Well, not really... The human body doesn't really differ between California, Alaska, North Dakota and Maryland (maybe there are different "chemicals" in the blood of the Californians, but you get the idea).

The range is a rough guideline of what is "normal." Normal heart rates vary from person to person... it really has to do with age, physical conditioning, and medical health.

To be honest, we have guides in the ambulances to help us with average vital sign ranges, as well as weights and drug dosages. I couldn't tell you off the top of my head what the average heart rate was for a 6-year-old... I'd have to look it up. From a BLS level, it really wouldn't change my treatment of a patient if their heart rate or BP was elevated or decreased... I'd just have to watch them closely, and would consider an ALS intercept.

In short - I don't think the NR or Region is going to give you a test with a question that asks for the normal range of pulse rates for a given age group... they MIGHT ask if 200 beats per minute is normal for an adolescent, but I doubt they'd even do that.

I hope this helps.

 

[ResTech]

Overall you just need to know the range. A HR outside of the "normal" range isnt recessarily "abnormal" for certain ppl. You have to assess your pt. and see how the HR correlates with the overall pt. presentation... as in, is the pt. symptomatic of the HR? If the HR is 40, which is bradycardia with normally symptomatic presentations, then you know your pt. is having a serious issue and needs the rate increased as they are hemodynamically compromised. But if you have a 30 y/o, super fit, marathon runner with a HR of 40, perfusing well, with no S/S of hemodynamic compromise then the HR really isnt any concern as this is the normal baseline for that pt. See the point?

For testing purposes, the only range for HR I seen referenced was for adults which is the 60-100 range. This is a pretty concrete range as it defines at what point a pt. is considered to have brady or tachycardia.

As others have said.... no magic numbers and no test is gonna look for a specific range. Just know that a HR less then 60 a pt. is considered to be bradycardic and a HR over 100 a pt. is considered to have tachycardia and you'll be fine.

 

[EMTalex]

Thanks guys, that really helps alot.

 

[Airwaygoddess]

Vital signs

Hi! I will just tell you right now that no question is ever stupid, It is better to ask and get an answer than to go "what if ". Anyhow, Every textbook gives us basic guidelines for V.S. and the age group that they fall under. I have learned that patients are not always in that "textbook guidelines". So if your pt. is alert, you can ask this what is normal their "normal V.S." You will be suprised at the answers that you will get. Still, treat your patients with the standing orders and protocals that have been estalished by the medical director of your country. In this job we all keep on learning!!