Are Pediatric Triage Systems Reliable in the Emergency Department?

Ebrahimi, Mohsen; Mirhaghi, Amir; Najafi, Zohre; Shafaee, Hojjat; Roudi, Mahin Hamechizfahm

doi:10.1155/2020/9825730

Cited by 8 publications

(8 citation statements)

References 34 publications

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“…The Canadian Triage and Acuity Scale (CTAS) was used in Geneva, consisting of the same five categories as the ATS, but with a difference in the time until doctor contact for triage scale 2, which was 15 min [ 29 ]. Both scales rate acuteness and severity in a very similar way [ 30 ]. For analysis purposes, triage scores 1–3, irrespective of triage scale, were considered as an urgent medical condition, while scores 4–5 were considered non-urgent.…”

Section: Methodsmentioning

confidence: 99%

The effect of the COVID-19 pandemic on pediatric emergency department utilization in three regions in Switzerland

von Rhein,

Chaouch,

Oros

et al. 2024

Int J Emerg Med

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Purpose The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However, contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future healthcare. Methods We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st, 2018—February 28th, 2022), analyzing the numbers of ED visits (including patients` age, triage categories, and urgent vs. non-urgent cases). The impact of COVID-19 related non-pharmaceutical interventions (NPIs) on pediatric ED utilization was assessed by interrupted time series (ITS) modelling. Results Based on 304′438 ED visits, we found a drop of nearly 50% at the onset of NPIs, followed by a gradual recovery. This primarily affected children 0–4 years, and both non-urgent and urgent cases. However, the decline in urgent visits appeared to be more pronounced in two centers compared to a third, where also hospitalization rates did not decrease significantly during the pandemic. A subgroup analysis showed a significant decrease in respiratory and gastrointestinal diseases, and an increase in the proportion of trauma patients during the pandemic. Conclusions The COVID-19 pandemic had substantial effects on number and reasons for pediatric ED visits, particularly among children 0–4 years. Despite equal regulatory conditions, the utilization dynamics varied markedly between the three regions, highlighting the multifactorial modification of pediatric ED utilization during the pandemic. Furthermore, future policy decisions should take regional differences into account.

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Section: Methodsmentioning

confidence: 99%

The effect of the COVID-19 pandemic on pediatric emergency department utilization in three regions in Switzerland

von Rhein,

Chaouch,

Oros

et al. 2024

Int J Emerg Med

View full text Add to dashboard Cite

show abstract

“…They were developed through group consensus and universally rely on some level of subjective judgment by trained triage providers to execute [15]. None of the above triage systems emerges as superior and similar performance trends and weaknesses are common to all systems [15,16]. Triage systems usually rely on an experienced triage nurse to undertake triage [17].…”

Section: How To Optimize Workflow In Paediatric Emergency Departments?mentioning

confidence: 99%

Modern Paediatric Emergency Department: Potential Improvements in Light of New Evidence

Kula¹,

Popela²,

Klučka³

et al. 2023

Preprint

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The increasing attendance of paediatric emergency departments becomes a serious health issue. To reduce an elevated burden of medical errors, inevitably caused by high level of stress exerted on emergency physicians, we propose potential areas for improvement in regular paediatric emergency departments. In effort to guarantee demanded quality of care to all incoming patients, the workflow in paediatric emergency departments should be sufficiently optimized. The key component remains implementing one of the validated paediatric triage systems upon patient's arrival at emergency department and fast-tracking patients with low level of risk according to the triage system. To ensure the patient's safety, emergency physicians should follow issued guidelines. Cognitive aids, such as well-designed checklists, posters or flow charts, generally improve physicians' adherence to guidelines and should be therefore available in every paediatric emergency department. To sharpen diagnostic accuracy, the use of ultrasound in paediatric emergency department, according to ultrasound protocols, should be targeted to answer specific clinical questions. Combining all mentioned improvements might reduce number of errors linked with overcrowding. The review serves not only as a blueprint for modernizing paediatric emergency departments, but also as a bin of useful literature which can be suitable in the paediatric emergency field.

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“…These triage systems are comparable ( Table 1 ) and share a standardised format: deploy a 5-level classification scheme and set targets for timeliness to physician contact per triage level [ 15 ]. None of the above triage systems emerges as superior, and similar performance trends and weaknesses are common to all systems [ 15 , 16 ].…”

Section: How To Optimise Workflow In Paediatric Emergency Departments?mentioning

confidence: 99%

Modern Paediatric Emergency Department: Potential Improvements in Light of New Evidence

et al. 2023

View full text Add to dashboard Cite

The increasing attendance of paediatric emergency departments has become a serious health issue. To reduce an elevated burden of medical errors, inevitably caused by a high level of stress exerted on emergency physicians, we propose potential areas for improvement in regular paediatric emergency departments. In an effort to guarantee the demanded quality of care to all incoming patients, the workflow in paediatric emergency departments should be sufficiently optimised. The key component remains to implement one of the validated paediatric triage systems upon the patient’s arrival at the emergency department and fast-tracking patients with a low level of risk according to the triage system. To ensure the patient’s safety, emergency physicians should follow issued guidelines. Cognitive aids, such as well-designed checklists, posters or flow charts, generally improve physicians’ adherence to guidelines and should be available in every paediatric emergency department. To sharpen diagnostic accuracy, the use of ultrasound in a paediatric emergency department, according to ultrasound protocols, should be targeted to answer specific clinical questions. Combining all mentioned improvements might reduce the number of errors linked to overcrowding. The review serves not only as a blueprint for modernising paediatric emergency departments but also as a bin of useful literature which can be suitable in the paediatric emergency field.

show abstract

Are Pediatric Triage Systems Reliable in the Emergency Department?

Cited by 8 publications

References 34 publications

The effect of the COVID-19 pandemic on pediatric emergency department utilization in three regions in Switzerland

The effect of the COVID-19 pandemic on pediatric emergency department utilization in three regions in Switzerland

Modern Paediatric Emergency Department: Potential Improvements in Light of New Evidence

Modern Paediatric Emergency Department: Potential Improvements in Light of New Evidence

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