Background- My experience until recently has been 3 years in an adult only ER. I now have a second per diem job in a a busier emergency department that sees a ton of kids, not a population I am familiar or very comfortable with yet. Last night I was in triage, and felt a little overwhelmed by how many kids came through and I realized I'm needing to review somethings and work on new skills! Its fun.
Here's my question to the community of experienced ER nurses!- At what age is it necessary and valuable to check a blood pressure on kids? Is this something you routinely do, or skip in kids with certain high ESI scores under a certain age?
This question occurred to me last night when I was going through my triage process like I would with a large person, and I was so exasperated to realize that IT IS NOT EASY to get a BP on crying squirming babies and toddlers, and furthermore, are the values even reliable when they are not calm? I wonder how useful a blood pressure is under a certain age when, as I know from PALS, children compensate their pressures and sick kids will have other poor perfusion signs first.
I bring this question here because when I asked some nurses I worked with last night, I got inconsistent ideas about practice. One nurse told me she measures BP on all patients, and another said that they don't measure on kids under 3 years.
When I look online for best practice, I found this interesting study ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385663/ ) which in summary, discusses that for kids with an ESI of 3 or 4, blood pressure may not be valuable in kids <5 years old.
I would like to hear what your practice is when triaging and caring for kids in the ED, or maybe be pointed in the direction of pediatric emergency standards of practice. Having a hard time finding definitive info from my Google searches.
THANKS!!!!
