Normal Respiratory Rate by Age
Shows the normal RR range (breaths per minute) for newborn, infant, child and adult.
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Normal respiratory rate: age-specific reference ranges
Respiratory rate (RR, breaths per minute, rpm) is among the first vital signs to shift when a patient starts to deteriorate. Resting reference ranges run like this: infant <1 y 30โ60 rpm; 1โ5 y 24โ40 rpm; 6โ12 y 18โ30 rpm; adolescent and adult 12โ20 rpm; elderly >65 y 12โ18 rpm, where amplitude drops a bit because the chest is less compliant. Count for a full 60 seconds while the patient isn't aware of it, ideally while you take the pulse. In an adult, tachypnea >24 rpm is an early warning of sepsis, pulmonary embolism, metabolic acidosis, or pneumonia. Bradypnea <10 rpm points toward opioid intoxication, CNS depression, or an arrest about to happen.
Clinical context
RR carries weight in several scores: NEWS2 (the adult early-warning tool, where โฅ25 rpm earns the maximum 3 points), qSOFA (โฅ22 rpm, one of its three sepsis criteria), and the PALS assessment in pediatrics. For children it is the best single bedside clue to pneumonia; WHO IMCI applies age-specific cut-offs of โฅ60 in <2 mo, โฅ50 in 2โ11 mo, and โฅ40 in 1โ5 y. What really counts is the trend rather than any one reading. A rate that climbs steadily over 4 hours often shows up hours ahead of cardiopulmonary arrest.
FAQ
Why is RR underreported? It's the vital sign most often skipped, according to audits, frequently charted as "16" or "18" when nobody actually counted. A trustworthy number takes a solid 60 s of attention.
What lowers RR physiologically? Sleep, sedation, opioids, hypothermia, raised intracranial pressure, and severe hypothyroidism can all bring it down. Read it together with SpO2 and mental status before drawing conclusions.
How do I count in infants? Watch the abdomen and chest move for 60 s with the baby calm. If the baby is feeding or crying the count won't be valid.
Tachypnea without dyspnea? Think metabolic acidosis (Kussmaul breathing). Check pH, lactate and ketones, and don't jump to a primary pulmonary cause.
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