A 3-year-old boy was recently admitted to the general paediatric ward of our hospital with a facial palsy. An automated blood pressure device could not provide a reading. However, 5 h after admission his severe hypertension of 210 mm Hg systolic was detected by a nurse from our renal unit using a manual sphygmomanometer. This incident highlighted the current lack of suitable equipment and the low confidence of staff in its usage.

We collected data on 70 consecutive medical admissions to seven paediatric wards. Blood pressure was recorded in only 56% of patients compared to 100% recording for heart rate, 93% for …