Pediatric Community

  • 1.  Frequency of Vital Signs in the ER (need help)

    Posted 11-28-2025 03:09 PM

    Hi. 

    Does anyone have a policy about how often you do vital signs on ER patients, specifically pediatric patients?

    For the past 10 years or so we have been doing them every 2 hours, even on stable patients and we feel this is a bit much, so are asking if anyone has a policy about how often they are repeated it would be great if you could share it with me. (Obviously if a patient is very sick they will be much more frequent)

    Thanks in advance!

    Louise McEvoy

    mcevoy16@yahoo.com

    Port Washington NY



    ------------------------------
    Louise McEvoy MS;BSN;RN;EMT-I;CPEN
    Registered Nurse
    Port Washington NY
    ------------------------------


  • 2.  RE: Frequency of Vital Signs in the ER (need help)

    Posted 11-29-2025 12:06 PM
    Louise,

    Rather than give you one answer, I would encourage you to go look at the EMS for Children Innovation and Improvement Center, Pediatric Readiness Toolkit.  Here's the link to the Policies Procedures and Protocols tab.  https://emscimprovement.center/domains/pediatric-readiness-project/readiness-toolkit/readiness-toolkit-checklist/policies/
    There are 5 vital signs policies and many more resources associated with the 7 domains of Pediatric Readiness.

    The main website is https://emscimprovement.center

    I hope that helps you find the answer you are looking for.

    Sally Snow 



    Original Message


  • 3.  RE: Frequency of Vital Signs in the ER (need help)

    Posted 12-01-2025 09:08 AM

    HI Louise, 

    I work at a stand-alone pediatric ER in CT.  We use the following guidelines related to VS reassessment for our patients.  It's all based on their ESI acuity initially, but more frequent as needed. 

    ESI 1 - every 15 minutes for at least the first 1 hour, then a discussion with provider about frequency (usually hourly)

    ESI 2 - every 1 to 2 hours

    ESI 3, 4 and 5 - every 4 hours at minimum, but we educate for around every 2-3 hours. 

    Thanks, 

    Jenn K 



    ------------------------------
    Jennifer Kemp MSN;RN
    RN
    Burlington CT
    ------------------------------

    Original Message


  • 4.  RE: Frequency of Vital Signs in the ER (need help)

    Posted 2 days ago

    Hi Louise!

    I absolutely agree with referencing the resources that Sally provided.

    In practice in our ER, it's based on ESI level (with the VS counter on Epic turning yellow if it's close to the time to needing vitals, and red if it's past the ESI related designated time. 

    For ESI Level 1 - initially q15 mins vitals (or more frequently as needed depending on condition), then provider guided frequency (usually q1hr when stable)

    For ESI Level 2 - minimum q2hr vital signs (this has presented a challenge with our psychiatric patients who are generally level 2s, so our providers write an order that they may receive q4-6hr vital signs as appropriate)

    For ESI Level 3, 4, 5 - minimum q4hr vital signs (with our general practice to also repeat VS 1hr after an antipyretic is administered).

    For patients receiving blood products or procedural sedation, we also have specific policies for vital signs timing, please let me know if you would like to know those policies!



    ------------------------------
    Tara Doherty, MSN, RN, CPEN, TCRN
    Pediatric Emergency Nurse
    NewYork-Presbyterian/Morgan Stanley Children's Hospital
    New York, NY
    ------------------------------

    Original Message