OBJECTIVE In triage of patients in the emergency department, nurses can identify conditions such as elevated blood pressure that can lead to serious health problems. It is imperative that the method used to evaluate blood pressure is dependable and accurate. The introduction of new technology may yield results that are not comparable to traditional measures. Therefore we compared the traditional auscultatory method of measuring blood pressure with the use of an automated device. METHODS The blood pressure of 100 healthy adult volunteers was measured first with the traditional cuff method and then with an automated device (IVAC model 4200). The measurements were recorded and then compared for each individual. RESULTS The mean difference between the paired systolic measurements was 4.3 mm Hg (p = 0.0001). The mean difference between the paired diastolic measurements was 1.3 mm Hg. There was a clinically significant difference (> 9 mm Hg) in 37% of the systolic readings and 26% of the diastolic readings. In 76% of those clinically significant systolic differences, the IVAC 4200 measurement exceeded the manual method. For the clinically significant diastolic differences, 58% of the IVAC 4200 measurements were greater than the manual method. CONCLUSION Clinicians must be cautious when using new technology to measure blood pressure. Results may not be comparable with results obtained with the traditional method.