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Reliability and validity of triage systems in paediatric emergency care.

van Veen M, Moll HA - Scand J Trauma Resusc Emerg Med (2009)

Bottom Line: The reliability of the MTS is good and reliability of the ESI is moderate to good.Reliability of the paedCTAS is moderate and is poor to moderate for the ATS.The internal validity is moderate for the MTS and confirmed for the CTAS, but not studied for the most recent version of the ESI, which contains specific fever criteria for children.Reliability of the MTS is good, moderate to good for the ESI and moderate for the paedCTAS.

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Affiliation: Department of Paediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.vanveen@erasmusmc.nl

ABSTRACT

Background: Triage in paediatric emergency care is an important tool to prioritize seriously ill children. Triage can also be used to identify patients who do not need urgent care and who can safely wait. The aim of this review was to provide an overview of the literature on reliability and validity of current triage systems in paediatric emergency care

Methods: We performed a search in Pubmed and Cochrane on studies on reliability and validity of triage systems in children

Results: The Manchester Triage System (MTS), the Emergency Severity Index (ESI), the Paediatric Canadian Triage and Acuity Score (paedCTAS) and the Australasian Triage Scale (ATS) are common used triage systems and contain specific parts for children. The reliability of the MTS is good and reliability of the ESI is moderate to good. Reliability of the paedCTAS is moderate and is poor to moderate for the ATS.The internal validity is moderate for the MTS and confirmed for the CTAS, but not studied for the most recent version of the ESI, which contains specific fever criteria for children.

Conclusion: The MTS and paedCTAS both seem valid to triage children in paediatric emergency care. Reliability of the MTS is good, moderate to good for the ESI and moderate for the paedCTAS. More studies are necessary to evaluate if one triage system is superior over other systems when applied in emergency care.

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Manchester Triage System flowchart Shortness of breath in children (Second edition). Reprinted with permission from Mackway-Jones K et al. Emergency Triage, Manchester Triage Group. Second edition. Oxford: Blackwell Publishing Ltd; 2006, p 134.[5]
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Figure 1: Manchester Triage System flowchart Shortness of breath in children (Second edition). Reprinted with permission from Mackway-Jones K et al. Emergency Triage, Manchester Triage Group. Second edition. Oxford: Blackwell Publishing Ltd; 2006, p 134.[5]

Mentions: The MTS contains 52 flowcharts presenting different presenting problems. Some flowcharts are specific for children, such as 'Worried parent', 'Abdominal pain in children', 'Crying baby', 'Shortness of breath in children', 'Limping child', 'Unwell child' and 'Irritable child'. The flowcharts contain general as well as specific discriminators, which are presenting signs or symptoms of the patient. General discriminators are life threat, pain, haemorrhage, conscious level, temperature and acuteness. [1] Specific discriminators are related to the presenting problems such as 'Increased work of breathing' (flowchart 'Shortness of breath in children') or 'Persistent vomiting' (flowchart 'Abdominal pain in children'). An example of a flowchart is provided in figure 1. (MTS flowchart 'Shortness of breath in children'). [5] The selected discriminator leads to an urgency level. Medical care should be delivered immediately for level 1, within 10 minutes for level 2, within 60 minutes for level 3, within 120 minutes for level 4 and within 240 minutes for level 5.


Reliability and validity of triage systems in paediatric emergency care.

van Veen M, Moll HA - Scand J Trauma Resusc Emerg Med (2009)

Manchester Triage System flowchart Shortness of breath in children (Second edition). Reprinted with permission from Mackway-Jones K et al. Emergency Triage, Manchester Triage Group. Second edition. Oxford: Blackwell Publishing Ltd; 2006, p 134.[5]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747834&req=5

Figure 1: Manchester Triage System flowchart Shortness of breath in children (Second edition). Reprinted with permission from Mackway-Jones K et al. Emergency Triage, Manchester Triage Group. Second edition. Oxford: Blackwell Publishing Ltd; 2006, p 134.[5]
Mentions: The MTS contains 52 flowcharts presenting different presenting problems. Some flowcharts are specific for children, such as 'Worried parent', 'Abdominal pain in children', 'Crying baby', 'Shortness of breath in children', 'Limping child', 'Unwell child' and 'Irritable child'. The flowcharts contain general as well as specific discriminators, which are presenting signs or symptoms of the patient. General discriminators are life threat, pain, haemorrhage, conscious level, temperature and acuteness. [1] Specific discriminators are related to the presenting problems such as 'Increased work of breathing' (flowchart 'Shortness of breath in children') or 'Persistent vomiting' (flowchart 'Abdominal pain in children'). An example of a flowchart is provided in figure 1. (MTS flowchart 'Shortness of breath in children'). [5] The selected discriminator leads to an urgency level. Medical care should be delivered immediately for level 1, within 10 minutes for level 2, within 60 minutes for level 3, within 120 minutes for level 4 and within 240 minutes for level 5.

Bottom Line: The reliability of the MTS is good and reliability of the ESI is moderate to good.Reliability of the paedCTAS is moderate and is poor to moderate for the ATS.The internal validity is moderate for the MTS and confirmed for the CTAS, but not studied for the most recent version of the ESI, which contains specific fever criteria for children.Reliability of the MTS is good, moderate to good for the ESI and moderate for the paedCTAS.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Paediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.vanveen@erasmusmc.nl

ABSTRACT

Background: Triage in paediatric emergency care is an important tool to prioritize seriously ill children. Triage can also be used to identify patients who do not need urgent care and who can safely wait. The aim of this review was to provide an overview of the literature on reliability and validity of current triage systems in paediatric emergency care

Methods: We performed a search in Pubmed and Cochrane on studies on reliability and validity of triage systems in children

Results: The Manchester Triage System (MTS), the Emergency Severity Index (ESI), the Paediatric Canadian Triage and Acuity Score (paedCTAS) and the Australasian Triage Scale (ATS) are common used triage systems and contain specific parts for children. The reliability of the MTS is good and reliability of the ESI is moderate to good. Reliability of the paedCTAS is moderate and is poor to moderate for the ATS.The internal validity is moderate for the MTS and confirmed for the CTAS, but not studied for the most recent version of the ESI, which contains specific fever criteria for children.

Conclusion: The MTS and paedCTAS both seem valid to triage children in paediatric emergency care. Reliability of the MTS is good, moderate to good for the ESI and moderate for the paedCTAS. More studies are necessary to evaluate if one triage system is superior over other systems when applied in emergency care.

Show MeSH
Related in: MedlinePlus