Hagedoorn NN, et al. - Researchers examined if and how hypotension in addition to tachycardia is associated with the Shock Index for serious illness. In this observational study, they assessed routine data collected from 10,698 children with measured BP (< 16 years). According to three age-adjusted clinical cut-offs (Advanced Pediatric Life Support, Pediatric Advanced Life Support and Pediatric Early Warning Score), hypotension is significantly associated with serious illness after adjusting for tachycardia, although its sensitivity is limited. Shock index had a correlation with serious illness, but they identified no acceptable cut-off value. Routine BP measurement to detect hypotension in all children was noted to have limited value in the ED.