Is a lack of recorded prehospital blood pressure an indicator of pediatric mortality?
The short answer is yes, pediatric trauma patients without blood pressures recorded from EMS had a higher mortality (4.3%) compared to pediatric patients that did have a recorded blood pressure (1.1%). This is based off of a prehospital study conducted in Japan.
Prehospital vital signs are left out more often in pediatric patients compared to adults. Of those vital signs that are recorded, blood pressure is the most common one left off.
There can be several barriers to obtaining a blood pressure on the pediatric patient in the prehospital setting: lack of properly sized equipment, an uncooperative child, and lack of education. However, the inability to obtain a blood pressure can also be due to the patient being more severely injured and having other skills performed or was unable to be obtained due to poor perfusion. In this study, those who did not have a recorded blood pressure also had a lower GCS score and a higher injury severity score.
References:
Shinohara et al. Association between blood pressure recording in prehospital setting and patient outcome in pediatric trauma patients: A prospective matching study. Journal of Trauma and Acute Care Surgery. July 2023. Epub ahead of print.
Keywords: pediatric trauma, vital signs, blood pressure