[Impact of a triage scale in a pediatric emergency department]

The pediatric nursing staff of the emergency unit has established a list of items for the triage of patients which can be used by the registered nurses. This scale defined 3 stages of severity.

1) to estimate the relevance of this list through the appraisal of the total time necessary to take care of the patients according to their severity stage, and the confrontation of the severity stage determined by the registered nurse and the severity stage determined by the paediatrician; 2) to determine a possible correlation between the severity stage and the rate of hospitalization.

This prospective study was carried out over a period of 1 month in winter for every child admitted in the pediatric emergency unit for medical reasons (traumatisms excluded).

One thousand six hundred and fifty-six children have been included in the study. Among them, 136 have been classified stage I, 1020 stage II and 500 stage III. The children have been taken care of in an average period of 20 min for stage I, 32 min for stage II, 43 min for stage III. The coherence rate between the severity stage determined by the nurse and the severity rate determined by the paediatrician was good. The rate of sub-estimation was low (4,2%). Nevertheless the reception nurses tend to overestimate the stage of severity in 17,6% of the cases. The prediction rate for hospital admittance was good: 68,7% of children classified in stage 1 were admitted, 23,5% of children in stage 2 and only 1,6% of children in stage 3.

Patients suffering from severe illnesses were taken care without injurious delay which was the main purpose of this list.