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Triage in the developing world--can it be done?

M A Robertson1, E M Molyneux

  • 1Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi.

Archives of Disease in Childhood
|August 23, 2001
PubMed
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Emergency Triage, Assessment, and Treatment (ETAT) guidelines reliably identify most children needing hospital admission in developing countries. Nurses effectively used these guidelines, showing their utility in pediatric emergency care.

Area of Science:

  • Pediatric Emergency Medicine
  • Global Health
  • Clinical Guidelines

Background:

  • Effective emergency triage is crucial for managing sick children in resource-limited settings.
  • Existing guidelines need validation in diverse healthcare environments.

Purpose of the Study:

  • To evaluate the performance of Emergency Triage, Assessment, and Treatment (ETAT) guidelines for sick children in a developing country.
  • To compare the accuracy of nurses versus advanced pediatric life support (APLS)-trained doctors in applying ETAT guidelines.

Main Methods:

  • A prospective study involving 2281 children presenting to an under-5 clinic in Malawi.
  • Simultaneous triage by nurses and assessing doctors using ETAT guidelines, with variations recorded.
  • Prioritization of patients into three categories based on ETAT criteria.

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Main Results:

  • Nurses identified a significant number of children needing emergency treatment or urgent assessment.
  • Discrepancies in prioritization between nurses and doctors were noted in 6.2% of cases, but these did not correlate with subsequent admissions.
  • 85% of admitted children were correctly categorized as requiring emergency or urgent care.

Conclusions:

  • The ETAT guidelines demonstrate reliability in identifying the majority of children who require hospital admission.
  • Nurses can effectively utilize ETAT guidelines for pediatric triage in developing world settings.