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The Effect of Pediatric Assessment Triangle and Pediatric Early Warning Score Triage on Success in Patient Assessment
Insights
The Pediatric Assessment Triangle and Pediatric Early Warning Score effectively triage pediatric patients in emergency departments. Both tools demonstrate high agreement with physician assessments and can be used concurrently for improved patient care.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Triage Tools
- Patient Outcomes
Background:
- Effective pediatric triage balances rapid assessment with objective monitoring.
- The comparative efficacy of the Pediatric Assessment Triangle (PAT) and Pediatric Early Warning Score (PEWS) in predicting critical outcomes is not fully established.
- This study evaluates PAT and PEWS in a pediatric emergency department.
Purpose of the Study:
- To evaluate and compare the effectiveness of the Pediatric Assessment Triangle and the Pediatric Early Warning Score.
- To assess their predictive capabilities for critical clinical outcomes in a real-world emergency setting.
Main Methods:
- A descriptive-correlational study involving 1964 patients in a pediatric emergency department.
- Triage using the Pediatric Assessment Triangle by nurses, with physician confirmation.
- The Pediatric Early Warning Score was used concurrently for one month.
- Analysis of agreement between PAT, PEWS, and physician triage results.
Main Results:
- High agreement between the Pediatric Assessment Triangle and physician triage (97.8%, kappa = 0.869).
- The Pediatric Early Warning Score significantly predicted hospitalization with 94.3% concordance to physician triage.
- Significant differences were observed between PAT and PEWS regarding hospitalization, length of stay, presentation, resource utilization, consciousness, and saturation levels (P < .001).
Conclusions:
- Both the Pediatric Assessment Triangle and the Pediatric Early Warning Score are effective tools for patient triage in pediatric emergency departments.
- These tools can be utilized together to enhance triage accuracy and patient management.
Introduction:
Effective pediatric triage requires a balance between rapid visual assessment and objective physiological monitoring; however, the comparative efficacy of the Pediatric Assessment Triangle and the Pediatric Early Warning Score in predicting critical clinical outcomes within real-world emergency settings is not yet fully established. This study aimed to evaluate and compare the effectiveness of the Pediatric Assessment Triangle and the Pediatric Early Warning Score used in the triage assessment of patients presenting to a pediatric emergency department.
Methods:
This descriptive-correlational study was conducted in the pediatric emergency department of a university hospital in July 2025 with 1964 patients. The Pediatric Assessment Triangle triage was performed by a nurse in the pediatric emergency department, and the physician triage was confirmed based on a physician's physical examination. The Pediatric Early Warning Score was used alongside the Pediatric Assessment Triangle for 1 month. The agreement between the Pediatric Assessment Triangle and the Pediatric Early Warning Score and the physician's triage results was analyzed.
Results:
Notably, 55.1% of the children were male, and the mean age was 6.10 ± 4.99 years; 95.2% of the children presented as outpatients, and the mean length of stay in the emergency department was 63.26 ± 96.96 minutes. The raw agreement level between the Pediatric Assessment Triangle and physician triage areas is 97.8% (kappa = 0.869). The Pediatric Early Warning Score was found to be significant in predicting hospitalization, and concordance with the physician triage result was 94.3%. Significant differences were found between the Pediatric Assessment Triangle and the Pediatric Early Warning Score in terms of hospitalization, length of stay in the emergency department, presentation, resource utilization, consciousness, and saturation levels (P < .001).
Discussion:
The findings demonstrate that the Pediatric Assessment Triangle and the Pediatric Early Warning Score are effective in patient triage in pediatric emergency departments and can be used together.
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