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This should be condition-specific, not age-specific. Babies get septic
shock too.

BP is a screen. It doesn't make sense to perform a screening test when
the specificity is poor. You end up chasing false positives all day.

Conditions where BP is indicated in children (I don't have our triage
protocols in front of me so I am going by memory)

Altered mental status
Major trauma
Tachycardia
Ingestion
Headache/seizure/stroke
Known or suspected renal disease
You could include fever in any immunocompromised child but this will be
detected first by tachycardia
Chest pain
Syncope
SOB/poor feeding in an infant
Most adolescents as a public health screen (this is not effective in
younger children because hypertension is so rare)

There may be other conditions I am forgetting

James Chamberlain, MD
Division Chief, Emergency Medicine
Children's National Medical Center
111 Michigan Avenue, NW
Washington, DC 20010
 
202.476.3253 (O)
202.476.3573 (F)
202.476.5433 (Emergency Access)

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Dawn B. Kendrick
Sent: Monday, April 19, 2010 10:25 PM
To: [log in to unmask]
Subject: Triage Vital Signs

Does anyone have triage guidelines for vital signs that state a blood
pressure only needs to 
be taken for those patients above a certain age? (for example, BP should
be taken for all 
patients age 3 and over) or are you taking them on all patients
(including infants), 
regardless of age?

If you are excluding based on age, can you give me a reference for this
exclusion?

Thanks

Dawn Kendrick

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