{
  "version": "1.0",
  "source": "Harriet Lane Handbook 23rd Edition reference values",
  "ageGroups": {
    "premie": {
      "label": "Premie",
      "hr": { "awake": "120-170", "sleeping": "100-150" },
      "rr": "40-70",
      "sbp": "55-75",
      "dbp": "35-45",
      "temp": "36.5-37.5",
      "weight": "0.5-2.5 kg",
      "spo2": "88-95% (target)",
      "notes": [
        "HR and RR are highly variable and depend on gestational age",
        "BP increases with gestational age and postnatal age",
        "Target SpO2 88-95% to reduce retinopathy of prematurity risk",
        "Temperature instability is common - use servo-controlled warmers",
        "Bradycardia (<100 bpm) and apnea are common in premature infants"
      ]
    },
    "0-3mo": {
      "label": "0-3 Months",
      "hr": { "awake": "100-150", "sleeping": "85-135" },
      "rr": "35-55",
      "sbp": "65-85",
      "dbp": "45-55",
      "temp": "36.5-37.5",
      "weight": "2.5-6 kg",
      "spo2": ">95%",
      "notes": [
        "HR normally increases with crying (up to 180-190 bpm) - this is physiologic",
        "Periodic breathing (pauses <10 sec) is normal in neonates",
        "Acrocyanosis (blue hands/feet) is normal; central cyanosis is not",
        "BP is best measured in the right arm (pre-ductal) in neonates",
        "Normal weight loss of 5-7% in first 3-5 days; regain by 10-14 days"
      ]
    },
    "3-6mo": {
      "label": "3-6 Months",
      "hr": { "awake": "90-120", "sleeping": "75-110" },
      "rr": "30-45",
      "sbp": "70-90",
      "dbp": "50-65",
      "temp": "36.5-37.5",
      "weight": "5-8 kg",
      "spo2": ">95%",
      "notes": [
        "Expected weight gain: 20-30 g/day (150-200 g/week)",
        "HR gradually decreases as vagal tone matures",
        "RR >60 at rest may indicate lower respiratory tract disease",
        "BP should be measured with appropriate cuff size (width 40% of arm circumference)"
      ]
    },
    "6-12mo": {
      "label": "6-12 Months",
      "hr": { "awake": "80-120", "sleeping": "70-110" },
      "rr": "25-40",
      "sbp": "80-100",
      "dbp": "55-65",
      "temp": "36.0-37.5",
      "weight": "8-10 kg",
      "spo2": ">95%",
      "notes": [
        "Expected weight: triple birth weight by 12 months (~10 kg average)",
        "Weight gain slows to ~10-15 g/day",
        "Sinus arrhythmia (HR varies with breathing) is normal",
        "Febrile tachycardia: HR increases ~10 bpm per 1 degree C above 37"
      ]
    },
    "1-3yr": {
      "label": "1-3 Years",
      "hr": { "awake": "70-110", "sleeping": "60-100" },
      "rr": "20-30",
      "sbp": "90-105",
      "dbp": "55-70",
      "temp": "36.0-37.5",
      "weight": "10-15 kg",
      "spo2": ">95%",
      "notes": [
        "Expected weight gain: ~200-250 g/month (2-2.5 kg/year)",
        "Tachycardia: HR >110 at rest warrants evaluation",
        "Tachypnea: RR >30 at rest may indicate respiratory distress",
        "BP screening begins at age 3 per AAP 2017 guidelines",
        "Estimated weight: 2 x (age in years) + 8"
      ]
    },
    "3-6yr": {
      "label": "3-6 Years",
      "hr": { "awake": "65-110", "sleeping": "55-100" },
      "rr": "20-25",
      "sbp": "95-110",
      "dbp": "60-75",
      "temp": "36.0-37.5",
      "weight": "14-20 kg",
      "spo2": ">95%",
      "notes": [
        "Annual BP screening recommended from age 3",
        "Normal BP <90th percentile for age, sex, and height",
        "Elevated BP: 90th to <95th percentile (or 120/80 if lower)",
        "Estimated weight: 2 x (age in years) + 8",
        "ETT size (uncuffed): (age/4) + 4"
      ]
    },
    "6-12yr": {
      "label": "6-12 Years",
      "hr": { "awake": "60-95", "sleeping": "50-85" },
      "rr": "14-22",
      "sbp": "100-120",
      "dbp": "60-75",
      "temp": "36.0-37.5",
      "weight": "20-40 kg",
      "spo2": ">95%",
      "notes": [
        "Resting HR >95 or <60 warrants evaluation",
        "BP should be measured at every clinical encounter",
        "Stage 1 HTN: >=95th percentile on 3 separate occasions",
        "Estimated weight: 3 x (age in years) + 7",
        "ETT size (cuffed): (age/4) + 3.5"
      ]
    },
    ">12yr": {
      "label": ">12 Years",
      "hr": { "awake": "55-85", "sleeping": "45-75" },
      "rr": "12-18",
      "sbp": "110-135",
      "dbp": "65-85",
      "temp": "36.0-37.5",
      "weight": "40-80 kg",
      "spo2": ">95%",
      "notes": [
        "Vital signs approach adult values",
        "From age 13: use adult BP thresholds (AAP 2017)",
        "Normal: <120/<80 mmHg; Elevated: 120-129/<80 mmHg",
        "Stage 1 HTN: 130-139/80-89 mmHg; Stage 2 HTN: >=140/>=90 mmHg",
        "Orthostatic vitals: measure lying, sitting, standing if dizzy",
        "Athletic bradycardia (HR 45-60) may be normal in trained adolescents"
      ]
    }
  }
}