Prevalence of blood pressure measurement in children at the emergency department of ibn- alatheer pediatric teaching hospital in mosul

Background: Blood pressure measurement is an integral part of physical examination in children but it is not commonly done in children. Although blood pressure measurement in children in theory should be routine in practice, it is rarely done. With increasing incidence of childhood obesity and the knowledge that blood pressure level in childhood and adolescence are predictive of adult hypertension, routine blood pressure measurement in children should be considered. Objectives: To determine the prevalence of blood pressure measurement in children presenting to the emergency department of Ibn - Alatheer Pediatric Teaching Hospital in Mosul and to evaluate if there was recognition and follow up of prehypertensive and hypertensive cases. Patients And Methods: A prospective observational chart review study of 604 children of both gender, aged between <2 – 14 years presenting to the emergency department over a 6 months period from the 1st of October 2017 to the 1st of April 2018. The sample was a convenience sample that was randomly collected, including patients presented in the emergency department at different times of the day and different days of the week. Data are obtained from the records of the patients including (age, gender, presenting signs and symptoms), blood pressure chart, weight and height. Blood pressure is measured by ascultatory method using sphygmomanometer with different standard cuffs. The blood pressure is performed by a resident doctor present at the emamergency department, and blood pressure plotted on blood Pressure percentile chart for age and sex is recommended by the second task force. Results: In total, 214 (35.4%) Patients had their blood pressure measured, 15 (7%) patients of them had blood pressure in the prehypertensive range (≥ 90th - < 95th percentile) with a lack of remeasure and follow up, and 65 (30.4%) patients in the hypertensive range (≥ 95th percentile), only 34 (52.3%) from 65 patients had their blood pressure remeasured, 16 patients had persistent hypertension, from them only 4 patients had evaluation, treatment, and referred to the pediatric ward. Blood pressure was measured more frequently in patients aged >2 – 14 years (38% – 53.3%) and blood pressure was measured more frequently in higher triage category patients 100% and in renal diseases 71% (secondary hypertension). Conclusion: Our study demonstrates that blood pressure measurement in children at the emamergency department was infrequent (35.4%) and inconsistent. Also there was a lack of follow up of prehypertensive and hypertensive cases.