Silverman M A, Walker A R, Nicolaou D D, Bono M J
St Agnes Healthcare, Department of Emergency Medicine, Baltimore, MD 21229, USA.
Am J Emerg Med. 2000 Nov;18(7):784-8. doi: 10.1053/ajem.2000.16311.
The study's objective was to assess the frequency of triage blood pressure measurements in pediatric patients and the recognition of an elevated blood pressure. The design was retrospective and included chart review. The setting consisted of four emergency departments associated with one medical school, including one level I academic center, two level II Community departments, and a regional children's hospital. A convenience sample of 437 patients, aged 1 month to 18 years, was selected. The frequency of triage blood pressure measurements was recorded. The number of patients whose blood pressure was higher than the 90th percentile for age and sex as established by the Second Task Force on Blood Pressure Control in Children was also recorded. The frequency of a second blood pressure measurement in patients with an elevated initial blood pressure was recorded. All frequency data were stratified by hospital and by age group. The results showed 294/437 (66%) of children had blood pressures measured at triage. Of these measurements, 153/294 (52%) reflected blood pressures greater than the 90th percentile for age and sex, but only 58/153 (38%) of patients with such blood pressures had a second blood pressure measured. Hospitals varied in their frequency of blood pressure measurement. Adolescents had their blood pressure measured more frequently, 981105 (93%) than two to 12-year-olds, 144/185 (78%) or 1-month to 2-year-olds, 52/147 (35%). Frequency of triage blood pressure measurements in children varied by institution and increased in frequency with age.
该研究的目的是评估儿科患者分诊时测量血压的频率以及对血压升高的识别情况。研究设计为回顾性研究,包括病历审查。研究地点包括与一所医学院相关的四个急诊科,其中有一个一级学术中心、两个二级社区科室和一家地区儿童医院。选取了437例年龄在1个月至18岁之间的患者作为便利样本。记录分诊时测量血压的频率。还记录了血压高于儿童血压控制第二次特别工作组确定的年龄和性别的第90百分位数的患者数量。记录初始血压升高的患者进行第二次血压测量的频率。所有频率数据按医院和年龄组进行分层。结果显示,294/437(66%)的儿童在分诊时测量了血压。在这些测量中,153/294(52%)的血压反映高于年龄和性别的第90百分位数,但血压如此之高的患者中只有58/153(38%)进行了第二次血压测量。各医院测量血压的频率有所不同。青少年测量血压的频率更高,为98/105(93%),高于2至12岁儿童,为144/185(78%)或1个月至2岁儿童,为52/147(35%)。儿童分诊时测量血压的频率因机构而异,且随年龄增长而增加。