Blood pressure measurements on children in the emergency department

Yuri Gilhotra1, Frank Willis

  • 1BC Children's Hospital, Vancouver, Canada.

Insights

Routine blood pressure (BP) measurement in children

Area of Science:

  • Pediatric Emergency Medicine
  • Cardiovascular Health
  • Public Health

Background:

  • No consensus exists on routine blood pressure (BP) measurement for pediatric emergency department (ED) visits.
  • Elevated childhood BP is linked to adult hypertension, highlighting the need for early detection.
  • Childhood obesity rates are rising, increasing the importance of monitoring pediatric BP.

Purpose of the Study:

  • To assess current practices of BP measurement in children at a tertiary pediatric ED.
  • To identify the frequency and consistency of BP monitoring in pediatric emergency care.

Main Methods:

  • Prospective observational study conducted over six months in 2003.
  • Involved 504 children presenting to the ED of Princess Margaret Hospital for Children.
  • Data collected on BP measurement rates and follow-up procedures.

Main Results:

  • BP was measured in only 22.6% of pediatric ED patients.
  • 30.7% of measured children had BP above the 95th percentile for age and sex.
  • BP remeasurement and follow-up for abnormal readings were infrequent.

Conclusions:

  • Current BP measurement in pediatric EDs is infrequent and inconsistent.
  • Further research is needed to establish the utility and feasibility of routine pediatric BP screening.
  • Implementing routine BP checks could enhance healthcare quality and future public health outcomes.
Abstract

Related Concept Videos

Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Measurement of Blood Pressure01:17

Measurement of Blood Pressure

Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
Sites for measuring blood pressure01:21

Sites for measuring blood pressure

Blood pressure measurement is a fundamental clinical procedure, providing crucial data for assessing cardiovascular health. Among the various sites for this measurement, the brachial and popliteal arteries are predominantly utilized due to their accessibility and the reliability of their readings. This lesson delves into the anatomical significance, methodology, and considerations of measuring blood pressure at these locations.
The Brachial Artery: Primary Site for Blood Pressure Measurement
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
Assessment of blood pressure in brachial artery(two-step method)01:23

Assessment of blood pressure in brachial artery(two-step method)

Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
Assessment of blood pressure in brachial artery(one-step method)01:15

Assessment of blood pressure in brachial artery(one-step method)

This procedural guide systematically measures blood pressure using an oscillometric digital sphygmomanometer, emphasizing accuracy, patient safety, and comfort.
Prepare for the Procedure: