Blood pressure measurements on children in the emergency department

Abstract

There is no consensus on routine blood pressure (BP) measurement for children presenting to the ED. By contrast, BP measurements are performed routinely in adult ED. With increasing childhood obesity, and the knowledge that elevated BP in childhood correlates with hypertension in adulthood, routine BP measurement in children should be considered. To review the current practice of BP measurement in children presenting to the ED of Princess Margaret Hospital for Children, Perth, Western Australia, a tertiary referral paediatric centre. A prospective observational study of 504 children presenting to the ED over a 6 month period in 2003. In total, 114 children (22.6%) had their BP measured. A total of 35 (30.7%) had a BP above the 95th percentile for age and sex. In total, 19 (54.3%) of 35 with abnormal BP had their BP remeasured. Only one child of 10 with consecutive hypertensive measurements was followed up. BP measurement was more common in children aged 2 years and above, and in higher triage category patients. The present study demonstrates that BP measurement in the ED is both relatively infrequent and inconsistent. Further research into this area is required to determine the usefulness and feasibility of routine BP measurements in children presenting to the ED. This might improve the quality of health care and positively impact on public health for the future.