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Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger
Alishah Mawji1, Edmond Li2, Clare Komugisha3
1Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, 217-2176 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada. alishah.mawji@bcchr.ca.
Insights
A new digital triage tool and patient tracking system can help identify critically ill children with sepsis faster. This smart technology aims to reduce treatment delays and improve outcomes in low-resource settings.
Area of Science:
- Pediatric critical care
- Digital health innovation
- Global health equity
Background:
- Sepsis is a leading cause of child mortality, particularly in low- and middle-income countries.
- Delayed diagnosis and treatment exacerbate sepsis-related morbidity and mortality.
- Limited clinical expertise hinders timely identification of at-risk children.
Purpose of the Study:
- To develop and evaluate a digital triage tool for identifying high-risk children with sepsis.
- To implement and validate a Radio-Frequency Identification (RFID) system for automated patient tracking.
- To reduce time to treatment initiation for critically ill children.
Main Methods:
- A pre-post intervention study design across three phases.
- Phase I: Baseline data collection on predictors and outcomes.
- Phase II: Model derivation, technology development, and usability testing.
- Phase III: Post-intervention data collection to assess effectiveness.
Main Results:
- The primary outcome is the comparison of time to treatment initiation before and after intervention.
- Effectiveness of the digital health intervention will be assessed.
- Data collection on key predictors and outcomes will be performed.
Conclusions:
- Smart technology can bridge the gap in clinical expertise for identifying at-risk children.
- A mobile health platform with real-time risk prediction can facilitate rapid triage.
- This solution aims to provide timely access to life-saving treatments in resource-limited areas.
Background:
Sepsis is the leading cause of death and disability in children. Every hour of delay in treatment is associated with an escalating risk of morbidity and mortality. The burden of sepsis is greatest in low- and middle-income countries where timely treatment may not occur due to delays in diagnosis and prioritization of critically ill children. To circumvent these challenges, we propose the development and clinical evaluation of a digital triage tool that will identify high risk children and reduce time to treatment. We will also implement and clinically validate a Radio-Frequency Identification system to automate tracking of patients. The mobile platform (mobile device and dashboard) and automated patient tracking system will create a low cost, highly scalable solution for critically ill children, including those with sepsis.
Methods:
This is pre-post intervention study consisting of three phases. Phase I will be a baseline period where data is collected on key predictors and outcomes before implementation of the digital triage tool. In Phase I, there will be no changes to healthcare delivery processes in place at the study hospitals. Phase II will involve model derivation, technology development, and usability testing. Phase III will be the intervention period where data is collected on key predictors and outcomes after implementation of the digital triage tool. The primary outcome, time to treatment initiation, will be compared to assess effectiveness of the digital health intervention.
Discussion:
Smart technology has the potential to overcome the barrier of limited clinical expertise in the identification of the child at risk. This mobile health platform, with sensors and data-driven applications, will provide real-time individualized risk prediction to rapidly triage patients and facilitate timely access to life-saving treatments for children in low- and middle-income countries, where specialists are not regularly available and deaths from sepsis are common.
Trial Registration:
Clinical Trials.gov Identifier: NCT04304235, Registered 11 March 2020.
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