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Reliability and validity of triage systems in paediatric emergency care
Mirjam van Veen1, Henriette A Moll
1Department of Paediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.vanveen@erasmusmc.nl
Insights
The Manchester Triage System (MTS) and Paediatric Canadian Triage and Acuity Score (paedCTAS) appear valid for paediatric emergency care. Reliability varies among systems, with MTS showing good reliability.
Area of Science:
- Emergency Medicine
- Paediatric Care
- Healthcare Systems
Background:
- Triage is crucial in paediatric emergency care for prioritizing critically ill children.
- It also identifies children who do not require immediate attention.
- This review examines the reliability and validity of current paediatric triage systems.
Purpose of the Study:
- To provide an overview of the literature on the reliability and validity of paediatric emergency care triage systems.
- To compare the performance of commonly used triage tools in children.
Main Methods:
- Literature search conducted in PubMed and Cochrane databases.
- Focused on studies evaluating the reliability and validity of triage systems specifically for children.
Main Results:
- Common systems include MTS, ESI, paedCTAS, and ATS.
- Reliability: MTS (good), ESI (moderate to good), paedCTAS (moderate), ATS (poor to moderate).
- Internal validity: MTS (moderate), paedCTAS (confirmed), ESI (not fully studied for recent version).
Conclusions:
- MTS and paedCTAS demonstrate validity for paediatric emergency triage.
- MTS offers good reliability, while ESI and paedCTAS show moderate reliability.
- Further research is needed to determine the superiority of any single system.
Background:
Triage in paediatric emergency care is an important tool to prioritize seriously ill children. Triage can also be used to identify patients who do not need urgent care and who can safely wait. The aim of this review was to provide an overview of the literature on reliability and validity of current triage systems in paediatric emergency care
Methods:
We performed a search in Pubmed and Cochrane on studies on reliability and validity of triage systems in children
Results:
The Manchester Triage System (MTS), the Emergency Severity Index (ESI), the Paediatric Canadian Triage and Acuity Score (paedCTAS) and the Australasian Triage Scale (ATS) are common used triage systems and contain specific parts for children. The reliability of the MTS is good and reliability of the ESI is moderate to good. Reliability of the paedCTAS is moderate and is poor to moderate for the ATS.The internal validity is moderate for the MTS and confirmed for the CTAS, but not studied for the most recent version of the ESI, which contains specific fever criteria for children.
Conclusion:
The MTS and paedCTAS both seem valid to triage children in paediatric emergency care. Reliability of the MTS is good, moderate to good for the ESI and moderate for the paedCTAS. More studies are necessary to evaluate if one triage system is superior over other systems when applied in emergency care.
