Normal Respiratory Rate by Age

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 30–60 rpm; 1–5 y 24–40 rpm; 6–12 y 18–30 rpm; adolescent and adult 12–20 rpm; elderly >65 y 12–18 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 ≥25 rpm earns the maximum 3 points), qSOFA (≥22 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 ≥60 in <2 mo, ≥50 in 2–11 mo, and ≥40 in 1–5 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.