Bradford VTS — Clinical Reference
🖥️ Desktop Consultation Toolbox
Everything you need, right where you need it — because no one has time to Google "normal paediatric heart rate" while a worried parent is sitting in front of them.
⚡ Quick access mid-consultation
🩺 Calculators, scores & clinical tools
🌐 Curated websites that actually deliver
Last updated: April 2026 | Created by Dr Ramesh Mehay, Bradford VTS
How to use this page: Bookmark it and keep it open during surgeries. Jump to any clinical section via the navigation above. If a link stops working, please email Dr Ram — he genuinely appreciates it.
Vital Signs Reference
Normal ranges by age, plus key clinical context
Heart Rate & Respiratory Rate by Age
| Age | HR (bpm) | RR (breaths/min) |
|---|---|---|
| <1 yr | 110–160 | 30–40 |
| 1–2 yrs | 100–150 | 25–35 |
| 2–5 yrs | 95–140 | 25–30 |
| 5–12 yrs | 80–120 | 20–25 |
| >12 / adult | 60–100 | 15–20 |
Paediatric Weight Estimation — APLS 6th Ed.
| Age | Formula | Example |
|---|---|---|
| <1 year | (0.5 × months) + 4 kg | 6 months = 7 kg |
| 1–5 years | (2 × years) + 8 kg | 3 yrs = 14 kg |
| 6–12 years | (3 × years) + 7 kg | 8 yrs = 31 kg |
⚠️ The old formula (Age+4)×2 is no longer recommended — it underestimates modern children's weight by ~33%. Use APLS 6th Ed. formulas above.
🌡️ Temperature
- Normal range: 36.1–37.2 °C
- Fever: >38 °C — treat clinically, not just the number
- Hypothermia: <35 °C — easy to miss in the frail elderly
- Rigors suggest bacteraemia — take seriously regardless of age
💧 O₂ Saturation (SpO₂)
- Normal: 95–100%
- Below 92% — consider urgent review
- Below 90% — very concerning in most adults
- COPD: target 88–92% (NICE QS10 / BTS guidance). Excess O₂ worsens CO₂ retention via Haldane effect, V/Q mismatch, and absorption atelectasis — not simply "hypoxic drive." Always ask what the patient's usual baseline is.
🩸 Capillary Refill Time (CRT)
- Normal: <2 seconds
- Press nail bed centrally for 5 secs, release
- Prolonged CRT → consider poor perfusion or sepsis
- Cold weather reduces reliability — use central CRT if uncertain
🩺 Blood Pressure — NICE NG136 (2023)
- Stage 1 HTN: Clinic ≥140/90 mmHg AND ABPM/HBPM ≥135/85 mmHg
- Stage 2 HTN: Clinic ≥160/100 mmHg AND ABPM/HBPM ≥150/95 mmHg
- Diagnose using ABPM (preferred) or HBPM — not clinic readings alone. ABPM/HBPM thresholds are 5 mmHg lower than clinic thresholds.
- Treatment targets: <80 yrs → aim <140/90 mmHg clinic; ≥80 yrs → aim <150/90 mmHg clinic
- Clinic BP ≥180/120: If accompanied by retinal haemorrhage/papilloedema OR life-threatening symptoms (confusion, chest pain, heart failure, AKI) → same-day specialist. If no such features → re-check within a week and consider treatment.
Cardiovascular Tools
Risk scores, anticoagulation, and thrombosis
AF & Stroke Risk
Anticoagulation Reference
Mental Health & Wellbeing
Validated screening tools and patient self-help
Suicidal Risk Assessment
Patient Self-Help Resources
💡 Trainee tip: Don't just hand out the Northumberland self-help booklets — read them yourself first. Knowing the content makes you far more credible when recommending them, and they're brilliant for SCA consultation practice too.
Respiratory Tools
Spirometry, PEFR, and sleep assessments
Peak Flow (PEFR)
Sleep & OSA
Inhaled Steroid Equivalence
Dementia & Cognition
Cognitive screening tools for primary care
Cancer Risk Tools
Risk calculators and referral decision support
Cancer Risk Calculators
Liver, Metabolic & Endocrine
Fatty liver scoring, BMI, and endocrinology references
Liver Fibrosis Scoring
Weight & BMI
Endocrinology Reference
MSK, Rheumatology & Orthopaedics
Fracture risk, joint scoring, and rheumatology monitoring
Osteoporosis & Fracture Risk
Joint & MSK Scoring
Rheumatology Drug Monitoring
Urgent & Acute Care
NEWS2, GCS, ambulance responses — for when things get serious fast
Early Warning & Severity
Ambulance & Referral
Infection & URTI Scoring
Sore throat, hepatitis serology, and travel health
Sore Throat Scoring
Serology Interpretation
Women's Health
Postnatal depression, pregnancy, and maternity tools
Postnatal Depression
Pregnancy
Urology
Prostate symptom assessment
Palliative & End of Life Care
Opioid conversion, bereavement tools, and palliative guidelines
Opioid Conversion
Bereavement Assessment
Palliative Guidelines
Renal Function
eGFR, CKD staging, and blood test interpretation
Renal Function
Master Calculator Databases
When you need something not listed above
Full Calculator Databases
Useful Websites by Category
A hand-picked collection of sites that actually get used in real GP consultations. Not every website ever created — just the ones that earn their bookmarks.