Pediatric Community

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

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

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Jennifer Kemp MSN;RN
RN
Burlington CT
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Jennifer, 

I love this method of determining how often vitals need to be assessed! At our facility, the standard in the ER is to assess vitals every 2-4 hours (unless the patient is unstable, for which it would be more frequent). However, I haven't heard of a set standard of how often to assess for non-stable patients, so I love this method of classifying how often to assess vitals based on their acuity! Thank you for sharing this!

Thank you!

Maira V

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Maira VanBeveren
Registered Nurse
Cedarville OH
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Original Message:
Sent: 12-01-2025 09:08 AM
From: Jennifer Kemp, MSN;RN
Subject: Frequency of Vital Signs in the ER (need help)

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 

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Jennifer Kemp MSN;RN
RN
Burlington CT
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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!

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