Normal vital signs chart

A normal vital signs chart lists the expected resting ranges for blood pressure, heart rate, respiratory rate, body temperature and oxygen saturation. It lets you judge a reading at a glance. For a healthy adult at rest, normal means blood pressure below 120/80 mmHg and a heart rate of 60 to 100 beats per minute. It also means 12 to 20 breaths per minute, a temperature of about 97.8°F to 99.1°F (36.5°C to 37.3°C) and SpO2 of 95% to 100%.

Children run faster than adults, so they need their own age bands. A newborn’s normal awake heart rate reaches 205 beats per minute, about double the adult ceiling.

This chart names the source behind every table, because the age bands shift depending on whose guidance you follow. Pediatric Advanced Life Support (PALS) ranges stop at age 15. The American Academy of Pediatrics switches to adult blood pressure thresholds at 13, and NEWS2 only scores patients aged 16 and over.

These are reference values for orientation. They don’t replace local protocol or clinical judgment, and your own documentation should state which source you follow.

Key takeaways

A normal vital signs chart compares blood pressure, heart rate, respiratory rate, temperature and SpO2 against expected resting ranges.

Healthy adults at rest sit below 120/80 mmHg, at 60 to 100 beats per minute and at 12 to 20 breaths per minute.

Children need age bands, and PALS puts a newborn’s awake heart rate at 100 to 205 against 60 to 100 for an adolescent.

The 2025 AHA/ACC guideline kept the 2017 blood pressure categories, and readings above 180/120 are now called severe hypertension.

Early warning scores such as NEWS2 add individual readings together, so several mildly abnormal values can trigger an urgent review.

What is a normal vital signs chart?

A normal vital signs chart is a clinical reference that lists expected values for the core measurements taken during an assessment. It gives nurses, physicians and front-line practice staff a fast comparison point when they record a reading.

The five classic vital signs are blood pressure, heart rate, respiratory rate, body temperature and oxygen saturation. Pain is sometimes added as a sixth, though adoption varies by institution.

A reference chart and a recording form do different jobs. The tables on this page tell you what normal looks like, while the downloadable form captures what you measured and how. Using both together means each reading is logged with the context someone needs to interpret it later.

Normal vital signs for adults

Adult resting values are the reference point most practices use first. The table below sets out the commonly accepted range for each parameter in a healthy adult at rest.

Heart rate and blood pressure follow American Heart Association (AHA) guidance. The temperature range is Cleveland Clinic’s adult reference, and 12 to 20 breaths per minute is the band NEWS2 scores as normal. A trained endurance athlete can rest below 60 beats per minute without any problem. Always read a value against the person in front of you.

Blood pressure categories for adults

Blood pressure is graded rather than simply marked normal or abnormal. The AHA uses five categories, and a reading falls into the highest category that either number reaches.

The 2025 AHA/ACC high blood pressure guideline replaced the 2017 version but kept these thresholds unchanged. What changed is the language at the top of the scale. The AHA now calls a reading above 180/120 without signs of organ damage severe hypertension, and the same reading with organ damage a hypertensive emergency.

Older charts group both under “hypertensive crisis,” so update any laminated copies on the wall. Our normal blood pressure chart covers the categories in more depth.

Normal heart rate and respiratory rate by age

Heart rate and respiratory rate both fall as children grow, so a single adult band misreads most pediatric patients. The table below uses one source for every pediatric row: The AHA’s Pediatric Advanced Life Support (PALS) reference ranges.

PALS stops at age 15, so the adult row repeats the adult ranges above for comparison. Some reproductions of the PALS table print the infant awake ceiling as 190 rather than 180, so check which figure your protocol uses.

The ranges narrow and slide down with each band, which is easier to see than to read in a table.

Notice how much the asleep and awake ranges differ. A sleeping infant at 95 beats per minute sits inside the asleep band but below the awake one. Record whether the child was asleep, calm or crying, or the next clinician can’t tell which band you used.

Newborn and infant vital sign ranges

Newborn readings need the most care because normal heart and breathing rates run so much faster than in adults. Under PALS, a newborn’s heart rate is 100 to 205 beats per minute awake and 90 to 160 asleep. Breathing runs at 30 to 53 breaths per minute.

Blood pressure starts low and climbs over the first year. PALS gives a typical systolic of 67 to 84 mmHg at four days old, rising to 72 to 104 mmHg across infancy.

Temperature matters most in the youngest babies. The American Academy of Pediatrics recommends a rectal reading under three months. A rectal temperature of 100.4°F (38°C) or higher in an infant aged two months or younger needs a pediatrician’s attention straight away.

For a fuller pediatric reference with a printable form, see our pediatric vital signs chart.

Pediatric blood pressure and temperature guidance

Heart rate and breathing rate have fixed bands, but children’s blood pressure and temperature need a different approach. Blood pressure depends on height and sex, and temperature depends on where you take it.

Pediatric blood pressure

The 2017 AAP clinical practice guideline classifies blood pressure in children aged 1 to 12 by percentile for age, sex and height. Each category uses the percentile or the fixed adult-style cut-off, whichever is lower:

• Normal: Below the 90th percentile.
• Elevated: At or above the 90th percentile, or 120/80 mmHg.
• Stage 1 hypertension: At or above the 95th percentile, or 130/80 mmHg.
• Stage 2 hypertension: At or above the 95th percentile plus 12 mmHg, or 140/90 mmHg.

From age 13, the AAP uses the same thresholds as the adult AHA table above. That is two years before PALS hands over to adult heart rate ranges, so a 13-year-old sits in two systems at once.

Low blood pressure is the more urgent finding in a sick child. PALS sets the systolic floor at 60 mmHg for newborns and 70 mmHg for infants. From 1 to 10 years, the floor is 70 plus twice the age in years, and from 10 onward it is 90 mmHg.

Normal temperature by measurement site

The average normal oral temperature is 98.6°F (37°C), according to MedlinePlus. Other sites read consistently higher or lower, so the same child can look feverish or normal depending on the thermometer.

A fever is usually a temperature of 100.4°F (38°C) or higher. Always write the site next to the number, because an armpit reading of 99.5°F tells a different story from an oral one. Our body temperature chart lists site-specific ranges in more detail.

Checklist for pediatric readings

• Check the age band first, then compare heart rate and respiratory rate.
• Note whether the child was asleep, calm or crying when you counted.
• Use a cuff sized to the child’s arm, because a cuff that is too small overstates blood pressure.
• Record the measurement method, especially for temperature and SpO2.
• Escalate according to local pediatric protocol when readings fall outside the band.

Normal oxygen saturation levels

Normal SpO2 for most healthy adults is 95% to 100%. Readings can run lower at altitude, and in people with long-term lung disease.

For acutely ill adults, British Thoracic Society guidance targets 94% to 98%. Patients at risk of hypercapnic respiratory failure, such as some people with COPD, have a lower target of 88% to 92%. NEWS2 scores them on a separate scale for that reason.

Pulse oximeter accuracy can be affected by skin pigmentation, poor perfusion, cold fingers, nail polish and movement. Treat an unexpected reading as a prompt to recheck the probe and the patient before acting on the number.

When vital signs are abnormal: Clinical red flags

An abnormal vital sign is a reading outside the expected range, and it may signal a problem that needs review. Several readings outside range together carry more weight than any single value.

• Blood pressure above 180/120 mmHg: Recheck after five minutes. With chest pain, breathlessness, weakness, vision change or difficulty speaking, the AHA advises calling 911.
• Heart rate outside the age band: A persistent reading above or below the band warrants review for tachycardia or bradycardia.
• Oxygen saturation below target: SpO2 under the patient’s target range needs review, and 91% or less scores 3 on NEWS2 by itself.
• Fever in a young infant: A rectal temperature of 100.4°F (38°C) or higher at two months or younger needs prompt pediatric assessment.
• Low blood pressure in a child: A systolic reading below the PALS floor for the child’s age is a sign of shock until proven otherwise.

Our abnormal vital signs chart lists the thresholds and next steps for each parameter.

How early warning scores combine vital signs

A single reading can look acceptable while the overall picture worsens. Early warning scores tackle this by adding readings together. The UK’s National Early Warning Score 2 (NEWS2), from the Royal College of Physicians, scores six parameters from 0 to 3:

• Respiration rate.
• Oxygen saturation, with 2 extra points if the patient needs supplemental oxygen.
• Systolic blood pressure.
• Pulse rate.
• Level of consciousness or new confusion.
• Temperature.

The total runs from 0 to 20, and the score sets the response:

NEWS2 is designed for adults aged 16 and over and isn’t used in pregnancy. Children are usually scored with a pediatric early warning score (PEWS), which varies between hospitals.

How to use the chart in clinical practice

Clinicians use the chart at the point of measurement, not after the notes are written. Pinning a printed copy near the observation station keeps the reference visible during busy shifts.

1. Select the age band that matches the patient before reading the table.
2. Let the patient rest for a few minutes, and take blood pressure seated with the arm supported.
3. Count respirations for a full minute without telling the patient, since people breathe differently when watched.
4. Record each measurement with its method, such as temperature site or SpO2 probe type.
5. Compare each reading with the band and mark any value outside it.
6. Escalate according to local protocol, noting the time and the person informed.
7. Repeat the full set of observations when the clinical picture changes.

Documentation best practice for vital signs

Vital signs are often the first objective evidence of a change in a patient’s condition. Inaccurate or missing entries make later decisions harder to defend.

A reading is only useful if the next clinician can interpret it. Each entry should capture:

• The value and its unit.
• The date and time of measurement.
• The method or site, such as rectal temperature or manual blood pressure.
• The patient’s position and state, such as seated, asleep or crying.
• Any oxygen the patient was receiving at the time.
• Who took the reading and which reference ranges they used.
• Any action taken, and who was informed.

Consistent recording also supports audit and handover. Trends matter more than single values, so store readings where you can compare them across visits. Our vital sign sheets give you a structured layout for repeat observations.

How Pabau keeps vital signs in the patient record

Paper charts work until you need to compare this month’s blood pressure with last spring’s. Then someone digs through folders, and readings taken by different staff use different units and methods.

With practice management software like Pabau, you can turn the fields on this chart into a digital form. Staff record each reading with its method, and the form saves straight to the patient’s Client record.

Previous readings sit alongside clinical notes, so you can spot a creeping blood pressure without a second spreadsheet. See how medical records management works in Pabau.

For family medicine and private GP teams, our primary care practice software brings booking, records and billing into the same system.

Record and track vital signs in one place

Pabau turns your vital signs chart into a digital form that saves each reading to the patient record. Your team can compare results across visits and spot changes early.

Book a demo

Conclusion

A vital signs chart is only as good as the source behind it. Pick one reference set per age group, write it into your protocol, and make sure every printed chart in the building matches it.

Then focus on what the numbers can’t tell you alone: The trend. A heart rate of 98 is normal, but not if it was 72 an hour ago. Record the method and the state with every reading, and give your team a way to see readings side by side.

Book a demo to see how Pabau helps your practice record vital signs once and track them across every visit.

Continue your research

Treating older patients? Elderly blood pressure chart sets out the targets and readings that matter for patients over 65.

Working with children? Pediatric blood pressure chart covers percentile-based readings for children and adolescents.

Checking a sleeping patient? Sleeping heart rate chart shows how resting heart rate drops overnight by age.

Need to grade a fever? Fever temperature chart breaks down fever thresholds by age and measurement site.

Assessing a head injury or stroke? Neurological vital signs explains the checks that sit alongside standard observations.

Frequently asked questions about normal vital signs