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Acta pediátrica de México
versão On-line ISSN 2395-8235versão impressa ISSN 0186-2391
Resumo
AVILES-MARTINEZ, Karla Isis et al. Triage, priorization tools of pediatric emergency room. Acta pediatr. Méx [online]. 2016, vol.37, n.1, pp.4-16. ISSN 2395-8235.
The Pediatric Triage is a preliminary structured clinical assessment process to prioritize care degree of emergency, identify vital risk, ensure the reassessment for patients that should wait for attention, decide the most appropriate area to care for them and optimize the quality of care.
Objective:
Determine the usefulness of the Pediatric-Assessment-Triangle (PET), Pediatric-Early-Warning-System (PEWS) and SAVE A CHILD for the proper identification and initial rating of the severity of illness of children in Triage.
Material and methods:
Diagnostic test transversal study conducted in the Emergency Pediatric Room (EPR). Inclusion criteria: income from triage. Exclusion criteria: children already hospitalized, income from administrative case. Simple random sampling. It began with the classification by a Pediatrician in triage and allocation of severity (I-VI) by The Canadian Paediatric Scale (PaedCTAS) as a reference standard. Parallel data collection for PET, SAT and SAVE A CHILD. The data obtained were corroborated for a second pediatrician to provide definitive care.
Results:
1120 children were assessed; 560 were admitted directly from triage to bed EPR (84.6% classified as level I, II or III) and 560 initially reviewed in office triage (20.2% level II or III). We obtained as a diagnostic test for PaedCTAS, sensibity = 82%, specificity = 80%, LR+ = 4.16 (OR 4.99; p < 0.001); PET sensibity = 81%, specificity = 87%, LR+ = 5.2 (OR 92.3; p < 0.001 ); SAVE A CHILD sensibity = 90%, specificity = 85%, LR+ = 1.2 (OR 15.2; p < 0.001).
Conclusions:
The study showed that PET, PEWS and SAVE A CHILD were useful tools to identify and classify the severity initial of disease in triage. The best result was obtained when employed they were used together.
Palavras-chave : Emergency; Emergency Pediatric Room; assessment; triage.