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Determines the age-based 5th-percentile systolic blood pressure threshold below which hypotension is defined in children (PALS/AAP): < 60 mmHg in term newborns to 1 month, < 70 mmHg in infants 1–12 months, < 70 + (2 × age in years) in children 1–10 years, and < 90 mmHg beyond 10 years. Compares a measured systolic blood pressure against the threshold.
Hypotension threshold (SBP 5th percentile): < 60 mmHg (0–1 month); < 70 mmHg (1–12 months); < 70 + 2 × age(years) mmHg (1–10 years); < 90 mmHg (> 10 years).
Systolic blood pressure at or above the age-specific 5th-percentile threshold is considered adequate perfusion pressure for resuscitation purposes; below the threshold defines hypotension requiring intervention.
Pediatric Advanced Life Support (PALS) defines hypotension as systolic blood pressure below the 5th percentile for age, commonly summarized as: < 60 mmHg for term newborns to 1 month, < 70 mmHg for infants 1–12 months, < 70 + (2 × age in years) mmHg for children 1–10 years, and < 90 mmHg for children older than 10 years. These thresholds are used to recognize hypotensive (decompensated) shock and trigger immediate intervention, but they are only one component of the PALS systematic assessment of perfusion.
Specialty
PediatricsCategory
PediatricsDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-16
Formula
Keywords
Normal Range
Systolic blood pressure at or above the age-specific 5th-percentile threshold is considered adequate perfusion pressure for resuscitation purposes; below the threshold defines hypotension requiring intervention.
| Classification | Range |
|---|---|
0–1 month Term newborn to 1 month | < 60 mmHg |
1–12 months Infant | < 70 mmHg |
1–10 years e.g., < 78 mmHg at 4 years | < 70 + (2 × age) mmHg |
> 10 years Older child / adolescent | < 90 mmHg |
Provides the age-based PALS 5th-percentile systolic blood pressure threshold for pediatric hypotension (< 60 mmHg in term newborns to 1 month; < 70 mmHg in infants 1–12 months; < 70 + 2 × age in years in children 1–10 years; < 90 mmHg beyond 10 years) and compares a measured systolic blood pressure against it.
A measured systolic blood pressure at or above the age-specific 5th-percentile threshold is considered adequate for resuscitation purposes. A systolic blood pressure below the threshold defines hypotension by PALS criteria and warrants immediate intervention with the shock algorithm.
Recognizing hypotension is a cornerstone of pediatric resuscitation; age-appropriate thresholds ensure that shock is identified early and treated before cardiovascular collapse, improving outcomes in pediatric emergency and critical care.
A 4-year-old in the emergency department has a measured systolic blood pressure of 85 mmHg.
Inputs:
NOT hypotensive — measured SBP 85 mmHg is at or above the PALS threshold for a 4-year-old (70 + 2 × 4 = 78 mmHg); assess for compensated shock.
70 + (2 × 4) = 78 mmHg. A systolic blood pressure below 78 mmHg in a 4-year-old is defined as hypotension by the PALS criteria.
No. Blood pressure is a late sign of shock; a child in compensated shock may have a normal blood pressure but abnormal perfusion, so assess capillary refill, pulses, urine output, and mental status as well.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. A normal blood pressure does not exclude shock; always assess perfusion, mental status, and urine output alongside blood pressure.
Early shock screening in children and adults
Perfusion pressure monitoring