• Jessica N Stewart, David McGillivray, John Sussman, and Bethany Foster.
• Division of Emergency Medicine, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. jnellstewart@hotmail.com
• J. Pediatr. 2008 Oct 1;153(4):478-83.

ObjectiveBlood pressure (BP) is measured at triage in most emergency departments (EDs). We aimed to determine the value of triage BP in diagnosing hypotension and true hypertension in children age > or =3 years presenting with nonurgent problems.Study DesignIn this prospective study, eligible children underwent automated BP measurement at triage. If BP was elevated, then the measurement was repeated manually. Children with a high manual BP were followed. True hypertension was defined as a manual BP >95th percentile for sex, age, and height measured on 3 occasions.ResultsAutomated triage BP was measured in 549 children (53.4% male; mean age, 9.4 +/- 4.3 years) and was found to be elevated in 144 of them (26%). No child was hypotensive. Among the 495 patients with complete follow-up, the specificity and positive predictive value (PPV) of elevated triage BP in diagnosing true hypertension were 81.8% and 0%, respectively. A sensitivity analysis including those with incomplete follow-up, in which the population prevalence of true hypertension was assumed to be 1% to 2%, resulted in a specificity of 74.5% to 75.3% and a PPV of 3.8% to 7.5%.ConclusionsThe yield of measuring BP at triage in children with nonurgent problems appears to be extremely low.

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