Antonella Ardolino1, C Ronny Cheung2, Thomas Lawrence3, Omar Bouamra3, Fiona Lecky4, Kathleen Berry5, Mark Lyttle6, Damian Roland7, Nadeeja Koralage8, Shabara Issa8, Adeel Chaudhary9, Ian Maconochie9. 1. Royal Hampshire Hospital, Winchester, UK. 2. Department of Paediatrics, St Thomas' Hospital, London, UK. 3. The Trauma Audit and Research Network, University of Manchester, Hope Hospital, Salford, UK. 4. University of Manchester/Salford Royal Hospital, Salford, UK Health Services Research Group, School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK. 5. Birmingham Children's Hospital, Birmingham, UK. 6. Bristol Royal Hospital for Children, Bristol, UK. 7. University of Leicester, Leicester, UK. 8. St Marys Hospital, Imperial College NHS Healthcare Trust, London, UK. 9. Leicester Royal Infirmary, Leicester, UK.
Abstract
OBJECTIVE: To investigate the performance characteristics in children with moderate and minor injuries of prehospital paediatric triage tools currently in use in England for identifying seriously injured children. METHODS: Eight prehospital paediatric triage tools were identified from literature review and a survey of the lead trauma clinicians across the 10 English strategic health authorities. Retrospective clinical data from 2934 patient records collected by four emergency departments were used to analyse each tool. A target sensitivity of >95% and specificity of 50-75% was set based on the literature. RESULTS: Three tools (East Midlands, North West and Northern) demonstrated acceptable sensitivity (all 100%). The other five tools fell below the target sensitivity of >95%. All eight tools had acceptable specificity (with results between 79% and 99%). CONCLUSIONS: Three tools (East Midlands, North West and Northern) demonstrated acceptable over- and under-triage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To investigate the performance characteristics in children with moderate and minor injuries of prehospital paediatric triage tools currently in use in England for identifying seriously injured children. METHODS: Eight prehospital paediatric triage tools were identified from literature review and a survey of the lead trauma clinicians across the 10 English strategic health authorities. Retrospective clinical data from 2934 patient records collected by four emergency departments were used to analyse each tool. A target sensitivity of >95% and specificity of 50-75% was set based on the literature. RESULTS: Three tools (East Midlands, North West and Northern) demonstrated acceptable sensitivity (all 100%). The other five tools fell below the target sensitivity of >95%. All eight tools had acceptable specificity (with results between 79% and 99%). CONCLUSIONS: Three tools (East Midlands, North West and Northern) demonstrated acceptable over- and under-triage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Emergency Department; Major Trauma Management; Paediatric Injury; Pre-Hospital; Trauma
Authors: Nabeela S Malik; Saisakul Chernbumroong; Yuanwei Xu; James Vassallo; Justine Lee; Christopher G Moran; Tina Newton; G Suren Arul; Janet M Lord; Antonio Belli; Damian Keene; Mark Foster; Timothy Hodgetts; Douglas M Bowley; Georgios V Gkoutos Journal: EClinicalMedicine Date: 2021-08-23