Is this child sick? Usefulness of the Pediatric Assessment Triangle in emergency settings

Fernandez, Antonio L.; Benito, Javier; Mintegi, Santiago

doi:10.1016/j.jped.2017.07.002

Cited by 17 publications

(9 citation statements)

References 20 publications

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“…Realistically, the implementation of a pediatric triage system in an ED may take between 9 and 12 months. 8 Many pediatric ED triage systems were validated and deemed reliable in the countries where they were developed, or in countries with similar sociodemographic and cultural conditions. There is evidence to support the validity and reliability of tools such as the MTS, PaedCTAS, ESI version 4, PEWS, POPS, and PAT in pediatric emergency services.…”

Section: Discussionmentioning

confidence: 99%

“…Reliability is described using the kappa statistic, where κ=0 indicates a random result and κ=1 shows total agreement between two or more measurements. 5,8…”

Section: Validation Of Triage Systemsmentioning

confidence: 99%

“…However, recording vital signs alone is not adequate to identify critically ill patients in an ED. 8,11 Color scales can have three (traffic light system), four, or five levels. Some of these instruments are used in private institutions without sufficient documentation and despite their questionable reliability.…”

Section: Pediatric Triage In Emergency Servicesmentioning

confidence: 99%

“…They have been recommended by national and international societies for emergency triage. 8,13 These levels are divided in increasing numerical or color order from levels 1 to 5, corresponding to immediate, very urgent, urgent, standard, and nonurgent. 14…”

Section: Pediatric Triage In Emergency Servicesmentioning

confidence: 99%

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Pediatric emergency triage systems

Simon

Schvartsman

Sukys

et al. 2023

Rev. paul. pediatr.

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Objective: The aim of this study was to perform a narrative review of the leading pediatric triage systems in emergency departments (EDs). Data source: Articles published between 1999 and 2019 were identified by searching the MEDLINE, EMBASE, and PubMed databases using the keywords “pediatric triage”, “pediatric assessment tools”, and “emergency department triage” with an emphasis on studies that evaluated the validation and reliability of triage systems. Data synthesis: A total of 105 articles on pediatric emergency triage systems in 12 countries were evaluated. Triage systems were divided into two groups: color-stratified triage systems and alert systems. The color-stratified triage systems included in this review were the Canadian Triage and Acuity Scale (CTAS), Manchester Triage System (MTS), Emergency Severity Index (ESI), and Australasian Triage Scale (ATS), and the alert systems included were the Paediatric Observation Priority Score (POPS), Pediatric Early Warning Score (PEWS), and Pediatric Approach Triangle (PAT). Evidence corroborates the validity and reliability of MTS, PaedCTAS, ESI version 4, PEWS, POPS, and PAT in pediatric emergency services. Conclusions: These are fundamental tools for risk classification of patients seeking treatment in EDs. Not all triage systems have been assessed for validity and reliability; nor are they well suited for all regions of the world. Employing triage systems in Brazil requires cultural adaptation and rigorous training of the local health staff, in addition to validation and reliability studies in our country, since the social and cultural context of this country differs from those where these tools were developed.

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Section: Discussionmentioning

confidence: 99%

“…Reliability is described using the kappa statistic, where κ=0 indicates a random result and κ=1 shows total agreement between two or more measurements. 5,8…”

Section: Validation Of Triage Systemsmentioning

confidence: 99%

Section: Pediatric Triage In Emergency Servicesmentioning

confidence: 99%

Section: Pediatric Triage In Emergency Servicesmentioning

confidence: 99%

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Pediatric emergency triage systems

Simon

Schvartsman

Sukys

et al. 2023

Rev. paul. pediatr.

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“…The increasing number of pediatric emergency department (ED) patients is a common and growing problem in recent years. In the United States, children account for approximately 40% of the ED patients; In the United Kingdom, 25–30% of the accident and emergency department visits are made by children [ 1 ]. Beck et al [ 2 ] reported that the non-urgent cases accounted for 68.4% of all cases in pediatric ED in Austria.…”

Section: Introductionmentioning

confidence: 99%

Using the Delphi method to establish pediatric emergency triage criteria in a grade A tertiary women’s and children’s hospital in China

Zhao

et al. 2022

BMC Health Serv Res

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Background We aimed to establish simplified and quantifiable triage criteria in pediatric emergency care, improving the efficiency of pediatric emergency triage and ensuring patient safety. Methods We preliminarily determined the pediatric emergency triage criteria with references to pediatric emergency department characteristics and internationally recognized triage tools after literature review and discussion. The final determination of the triage criteria was reached after two rounds of Delphi surveys completed by18 experts from 3 hospitals in China. Results Both round 1 and round 2 surveys had a 100% response rate. The overall expert authority coefficient in the two rounds of surveys was 0.872. The experts had 100% enthusiasm for participating in the surveys. Kendall’s coefficients of concordance for conditions/symptoms in patients triaged to level 1, 2, 3, and 4 were 0.149, 0.193, 0.102, and 0.266, respectively. All p-values were less than 0.05. The coefficients of variation in conditions/symptoms, vital signs, and the Pediatric Early Warning Score (PEWS) ranged between 0.00 and 0.205, meeting the inclusion criteria. The pediatric emergency triage criteria containing conditions/symptoms, vital signs, PEWS scores, and other 4 level 1 indicators, 51 level 2 indicators and 23 level 3 indicators were built. The maximum waiting time to treatment for the patients triaged to level 1, 2, 3, and 4 was immediate, within 10 min, within 30 min, and within 240 min, respectively. Conclusion The pediatric emergency triage criteria established in this study was scientific and reliable. It can be used to quickly identify the patients requiring urgent and immediate care, thereby ensuring the priorities for the care of critically ill patients.

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Basismaßnahmen und erweiterte Maßnahmen zur Wiederbelebung von Kindern

Voorde

Biarent

Bingham

et al. 2020

Notfall Rettungsmed

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Basismaßnahmen und erweiterte Maßnahmen zur Wiederbelebung von Kindern COVID-19-Leitlinien des European Resuscitation Council Einführung Kinder sind anfällig für die Coronaviruskrankheit 2019 (COVID-19), scheinen jedoch häufig nur einen milden Krankheitsverlauf zu haben [1-7]. Sehr kleine Kinder und Kinder mit Komorbiditäten sind möglicherweise anfälliger für schwere Krankheitsverläufe. In der größten derzeit veröffentlichten pädiatrischen Fallserie (chinesische CDC 01/16-02/08; n = 2143) hatten 5,2 % der Kinder einen schweren Krankheitsverlauf (definiert als "Dyspnoe, zentrale Zyanose und eine Sauerstoffsättigung von weniger als 92 %"), 0,6 % der erkrankten Kinder hatten einen kritischen Krankheitsverlauf [9]. Jedoch können viele andere Krankheitserreger und/oder Ursachen bei Kindern zu respiratorischem Versagen führen und es kann schwierig sein, eine eindeutige Diagnose zu stellen [10]. In Anbetracht dessen ist sich die ERC Pediatric Guideline Writing Group Diese Leitlinie wurde am 24. April 2020 erstellt und unterliegt den sich weiterentwickelnden Kenntnissen und Erfahrungen über COVID-19. Da sich die Länder in verschiedenen Stadien der Pandemie befinden, kann es in der Praxis zu Abweichungen in einzelnen Ländern kommen.

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Is this child sick? Usefulness of the Pediatric Assessment Triangle in emergency settings

Abstract: The Pediatric Assessment Triangle is quickly spreading internationally and its clinical applicability is very promising. Nevertheless, it is imperative to promote research for clinical validation, especially for clinical use by emergency pediatricians and physicians.

Cited by 17 publications

References 20 publications

Pediatric emergency triage systems

Pediatric emergency triage systems

Using the Delphi method to establish pediatric emergency triage criteria in a grade A tertiary women’s and children’s hospital in China

Basismaßnahmen und erweiterte Maßnahmen zur Wiederbelebung von Kindern

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