Blood pressure measurements on children in the emergency department
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.
Background:
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.
Objective:
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.
Method:
A prospective observational study of 504 children presenting to the ED over a 6 month period in 2003.
Results:
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.
Conclusions:
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.
Related Concept Videos
Special considerations while measuring blood pressure
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 Pressure
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Pre-Procedural Guidelines for Assessing Blood Pressure
Assessment of blood pressure in brachial artery(two-step method)
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:


