Child: CVS examination

The pulse must be measured on all four extremities. Usually the two radial pulses and the two inguinal pulses are palpated. It is very important that an infant's inguinal pulses are palpated during examination. In babies the recapitulation time of the skin tests the adequacy of the peripheral circulation. It is examined by pressing the blood out of the skin with the finger for a few seconds. When the pressure is released, the area should return to its normal rosy pink hue within two to three seconds. The nail bed is also suitable for this test.

Any delay in recapitulation points to a centralized circulation. This can be one of the early signs of infection in young babies. If blood pressure is to be measured according to the classical Riva Rochi method, the size of the cuff must be adapted to the child's arm length. We normally choose a cuff equal to two-thirds of the length of the child's upper arm. The pressure release rate should be slow, about three millimeters per second. Blood pressure values and cuff size are related in the following way. A cuff which is too small will give a value which is too high.

A cuff which is too big shows too low a blood pressure. Measuring the blood pressure of newborn infants and babies is difficult. It's best to use an electro-oscillographic apparatus. Blood pressure is age-dependent. In newborn babies, it averages 70 over 50. It rises in the course of development until at the age of 10, it averages 110 over 70.