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Validity of triage systems for paediatric emergency care: a systematic review

Maria Clara de Magalhães-Barbosa1, Jaqueline Rodrigues Robaina1, Arnaldo Prata-Barbosa1,2

  • 1Department of Paediatrics, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.

Emergency Medicine Journal : EMJ
|October 6, 2017
PubMed

Insights

This review found evidence supporting the validity of the Manchester Triage System (MTS), Canadian Triage and Acuity Scale (PedCTAS), and Emergency Severity Index (ESI v.4) for pediatric emergency care. Continued efforts are needed to improve sensitivity and reduce undertriage rates.

Area of Science:

  • Emergency Medicine
  • Pediatric Care
  • Health Systems Research

Background:

  • Paediatric emergency care relies on accurate triage systems to prioritise patient needs.
  • The validity of various paediatric triage systems requires systematic evaluation.

Purpose of the Study:

  • To systematically review the validity of established triage systems for paediatric emergency care.
  • To identify which systems demonstrate the most robust evidence for accuracy.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (MEDLINE, LILACS, etc.) with no time restrictions.
  • Included studies focused on five-level triage systems for patients aged 0-18 years.
  • Data extraction and quality assessment followed PRISMA guidelines.

Main Results:

  • Twenty-five studies evaluated seven triage systems, including the Manchester Triage System (MTS), paediatric Canadian Triage and Acuity Scale (PedCTAS), and Emergency Severity Index version 4 (ESI v.4).
  • MTS, PedCTAS, and ESI v.4 had the most moderate and high-quality studies, showing consistent association with hospitalisation and resource use.
  • Undertriage was identified across systems, with low-urgency patients being hospitalised.

Conclusions:

  • The MTS, PedCTAS, and ESI v.4 show evidence of validity in their respective regions.
  • Further research should focus on enhancing sensitivity and minimizing undertriage.
  • Cross-cultural adaptation is crucial for successful implementation in new settings.
Abstract

Keywords:
emergency departmentpediatricstriagevalidity

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