PedsVitals 🧸❤️

The Story

I’m Henry, a medical student in Hamilton, Ontario, and I’m currently about a third of the way through clerkship. I’ve always been a little intimidated by pediatrics because it feels like kids are an entirely different species (like little aliens 👽). They are affected by different diseases, require different medication dosages, and their vitals are completely different compared to adults. Developmental milestones were also extremely hard for me to remember just because of how many milestones and categories there were. As I was starting my pediatrics rotation, I remember struggling to learn all the numbers and ranges that varied between age and sometimes gender and height too, and thinking to myself how I could possibly function as a clerk on the wards and in the emergency department.

That’s when I came up with the idea for the PedsVitals Card. I did a quick search on Amazon and found a couple similar products—but they were either sold in packs of 6, including superfluous cards such as kg-lbs or Celsius-Fahrenheit conversions which I didn’t need, or items that cost $15 in shipping. Plus, each card sold for more than $5 each, which I thought was a lot. So I decided to make my own.

My goals were to create a resource that was

I made a few prototypes at Staples, fulfilled my first orders to some of my classmates, and created my first batch, ready to be easily mailed out in an envelope anywhere in Canada!

Total orders: 37, 0 left.

Who is this for?

MD students, nursing students, PA students, and anyone else rotating through pediatrics.

The Product

Here’s what it looks like, front and back, attached to my hospital ID cards.

I used some abbreviations in an effort to conserve space:

1. wt = weight
2. wk = week
3. mo = month
4. yr = year
5. HR = heart rate
6. RR = respiratory rate
7. SBP = systolic blood pressure
8. 50%ile = 50th percentile
9. str anxiety = stranger anxiety
10. ant font = anterior fontanelle
11. birth len = birth length
12. trike = tricycle

The Science

Keeping with my first goal, I wanted to be as transparent as possible with my sources to convince you that the information on the PedsVitals Card is trustworthy.

Heart rate (HR) and respiratory rate (RR) are age dependent, while blood pressure is based on age, sex, and height.

1. The 50th percentile values for HR and RR are based on the centile charts in a systematic review published by Fleming et al. in the journal Lancet in 2011, based on heart rate data from 143,346 children and respiratory rate data from 3881 children. I used a plot digitizer to get the numerical values from the graphs.
2. The HR and RR ranges are based on the web appendix for the above Fleming study: Web Tables 4 and 5. They are reported as 1st centile to 99th centile ranges.
3. The 50th percentile systolic blood pressure (SBP) is based on the 50th percentile height-for-age, according to a study by Flynn et al. in the journal Pediatrics in 2017. This data was based on auscultatory measurements obtained from ~50,000 children and adolescents. For example, the 50th height percentile for 2-year-old girls is 91.1cm, and the 50th SBP percentile for that height and age is 89mmHg. Similarly, the 50th height percentile for 2-year-old boys is 92.1cm, and the 50th SBP percentile for that height and age is also 89mmHg. So I used that number for the ‘Toddler (1-3yr)’ category. I noticed the SBP did not vary significantly between sexes at least for the 50th height percentile, so I only included one value on the card for both sexes, for ease of use.
4. The ranges for SBP are from The Hospital for Sick Children (SickKids), arguably the leading pediatrics hospital in the country. Unfortunately the Flynn study did not report complete ranges across height centiles.
5. The 50th centile weight and weight ranges are based on the 3rd-97th centile ranges according to the WHO Growth Charts across sexes.
6. The developmental milestones are based on a pediatrics module on Aquifer, an online clinical learning resource our school used for our virtual online curriculum during the pandemic. A PDF summary is here.
7. The neonatal reflexes and time to disappearance is based on our school’s internal clinical skills manual.

How Can I Get One?

Great question! Fill out this form. They cost:

I am accepting e-transfers as the only form of payment at the moment, and can ship within Canada. Please keep in mind that I am a full-time student doing this for fun, so please allow some time for processing/delivery. All proceeds will be donated to the McMaster Children’s Hospital Foundation.

Usage Tips

The PedsVitals card comes laminated with a small hole (see pictures above).

1. The corners may be sharp, so cut around the edges to smooth it out if you’d like. You can use regular scissors or sandpaper (although I haven’t tried the sandpaper method myself).
2. Attach the card directly to your lanyard keychain. Keychain not included, sorry! But I am sure you can find one lying around in your house.
3. If the hole is not big enough, simply use a standard hole puncher to create a larger one over it (just do this carefully).

Feedback

Any feedback is welcome! This will help me update and improve the card where possible!

Disclaimer

I tried my best to make sure this reference is accurate and free of errors, but am not able to make a guarantee. Reference ranges, values, and developmental milestones are guidelines and you should always follow local protocol at your institution. Each patient’s individual clinical situation should always be taken into account. Please refer to the citations above. Thank you!