Pediatric triage: a 2-tier, 5-level system in the United States

Emergency care continues to be a challenge for the pediatric population. Pediatric emergency department (ED) visits have escalated to over 12.5 million/y. To provide quality care, the provider must strive to meet ED efficiency, patient safety, and federal regulations. One of the most critical and challenging areas is pediatric triage. International healthcare systems in Canada and Australia have designed national triage systems to address the needs of patient acuity, improve patient safety, and enhance customer satisfaction. The United States continues to have various triage systems that include 3-level, 4-level, and 5-level systems in a variety of ED settings. This paper describes a pediatric triage system in the United States with a 2-tier process for high volume and 5 levels of acuity for time to treatment with over 30,000 ED visits per year.