Related Experiment Video
Updated: Nov 20, 2025
Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers
Published on: March 14, 2018
A validity study of the rapid emergency Triage and treatment system for children
Siv Steinsmo Ødegård1,2, Thuy Tran3, Lars E Næss-Pleym4
1Department of Pediatrics, St. Olavs University Hospital, Trondheim, Norway. siv.steinsmo@gmail.com.
Insights
The Scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) accurately reflects medical urgency in children. This validated triage system effectively prioritizes pediatric patients based on condition severity.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Triage Systems
- Healthcare Quality Improvement
Background:
- The Scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) is widely used in Scandinavian pediatric emergency departments.
- RETTS-p integrates vital signs with a systematic symptom assessment for pediatric patient evaluation.
- The study aimed to validate the effectiveness of the RETTS-p system in a real-world clinical setting.
Purpose of the Study:
- To assess the validity of the RETTS-p triage system in a pediatric emergency department.
- To determine if RETTS-p priority ratings correlate with objective measures of disease severity.
- To evaluate the system's performance across different pediatric medical and surgical sub-disciplines.
Main Methods:
- A retrospective study analyzed triage data from 6,368 children over two years (2013-2014).
- Priority ratings were assigned using the RETTS-p system, evaluating vital signs and clinical manifestations.
- Validity was assessed by correlating triage ratings with hospitalization, length of stay, and pediatric intensive care unit referral.
Main Results:
- High RETTS-p priority ratings were significantly associated with increased hospitalization, longer hospital stays, and PICU referral.
- A dose-response relationship was observed between higher triage levels and indicators of severe disease (p-trend < 0.001).
- Sensitivity and specificity for proxy variables ranged from 54-83% and 66-57%, respectively; surgical patients received lower priority ratings than medical patients.
Conclusions:
- RETTS-p priority ratings effectively differentiate between varying levels of medical urgency in pediatric patients.
- The system demonstrates validity across a wide range of pediatric conditions, including both medical and surgical cases.
- RETTS-p is confirmed as a valid and reliable triage tool for use in university hospital pediatric emergency settings.
Background:
The Scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) is a reliable triage system that includes both assessment of vital parameters and a systematic approach to history and symptoms. In Scandinavia, the system is used in most pediatric emergency departments (PED). We aimed to study the validity of RETTS-p.
Methods:
We conducted a study based on triage priority ratings from all children assessed in 2013 and 2014 to the PED at St. Olavs University Hospital Trondheim, Norway. Patients were assigned one of four priority ratings, based on the RETTS-p systematic evaluation of individual disease manifestations and vital parameter measurements. In the absence of a gold-standard for true disease severity, we assessed whether priority ratings were associated with 3 proxy variables: 1) hospitalization to the wards (yes vs. no), 2) length of hospital stay (≤ mean vs. > mean, and 3) referral to pediatric intensive care (yes vs. no). We further compared priority ratings with selected diagnoses and procedure codes at discharge.
Results:
Six thousand three hundred sixty-eight children were included in the study. All analyses were performed in the entire population and separately in pediatric sub-disciplines, medicine (n = 4741) and surgery (general and neurosurgery) (n = 1306). In the entire population and the sub-disciplines, a high priority rate was significantly associated with hospitalization to wards, a longer hospital stay and referral to the pediatric intensive care unit compared to patients with low priority. We observed a dose-response relationship between increased triage code level and indicators of more severe disease (p-trend < 0.001). For the same three proxy variables, the sensitivity was 54, 61 and 83%, respectively, and the specificity 66, 62 and 57%, respectively. Subgroup analyzes within the most common complaints, demonstrated that more severe conditions were higher prioritized than less severe conditions for both medical and surgical patients. Overall, children with surgical diagnoses attained lower priority ratings than children with medical diagnoses.
Conclusions:
RETTS-p priority ratings varies among a broad spectrum of pediatric conditions and mirror medical urgency in both medical and surgical disciplines. RETTS-p is a valid triage system for children as used in a university hospital setting.
More Related Videos
11:27A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
07:20Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024