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Validity of the Canadian Paediatric Triage and Acuity Scale in a tertiary care hospital

Published online by Cambridge University Press:  21 May 2015

Jocelyn Gravel ,
Sergio Manzano  and
Michael Arsenault
Jocelyn Gravel*
Affiliation:
Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Que.
Sergio Manzano
Affiliation:
Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Que.
Michael Arsenault
Affiliation:
Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Que.
*
Pediatric Emergency Department, CHU Sainte-Justine, 3175 Che. Côte-Sainte-Catherine, Montréal QC H3T 1C5; fax 514 345-2358; graveljocelyn@hotmail.com

Abstract

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Objective:

We evaluated the validity of the Canadian Paediatric Triage and Acuity Scale (Paed-CTAS) for children visiting a pediatric emergency department (ED).

Methods:

This was a retrospective study evaluating all children who presented to a pediatric university-affiliated ED during a 1-year period. Data were retrieved from the ED database. Information regarding triage and disposition was registered in an ED database by a clerk following patient management. In the absence of a gold standard for triage, admission to hospital, admission to pediatric intensive care unit (PICU) and length of stay (LOS) in the ED were used as surrogate markers of severity. The primary outcome measure was the correlation between triage level (from 1 to 5) and admission to hospital. The correlation between triage level and dichotomous outcomes was evaluated by a χ2 test and an analysis of variance (ANOVA) was used to evaluate the association between triage level and ED LOS.

Results:

Over the 1-year period, 58 529 patients were triaged in the ED. The proportion admitted to hospital was 63% for resuscitation (level 1), 37% for emergent (level 2), 14% for urgent (level 3), 2% for semiurgent (level 4) and 1% for nonurgent (level 5) (p < 0.001). There was also a good correlation between triage levels and LOS and admission to PICU (both p < 0.001).

Conclusion:

This computerized version of PaedCTAS demonstrates a strong association with admission to hospital, admission to PICU and LOS in the ED. These results suggest that PaedCTAS is a valid tool for triage of children in a pediatric ED.

Keywords

triagepediatricvalidity
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 1 , January 2009 , pp. 23 - 28
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

1.McDonald, L, Butterworth, T, Yates, DW. Triage: a literature review 1985–1993. Accid Emerg Nurs 1995;3:201–7.Google Scholar
2.O’Neill, KA, Molczan, K. Pediatric triage: a 2-tier, 5-level system in the United States. Pediatr Emerg Care 2003;19:285–90.Google Scholar
3.Beveridge, R. CAEP issues. The Canadian Triage and Acuity Scale: a new and critical element in health care reform. Canadian Association of Emergency Physicians. J Emerg Med 1998;16:507–11.Google Scholar
4.Derlet, R, Richards, J, Kravitz, R. Frequent overcrowding in U.S. emergency departments. Acad Emerg Med 2001;8:151–5.CrossRefGoogle ScholarPubMed
5.Taylor, TB. Threats to the health care safety net. Acad Emerg Med 2001;8:1080–7.Google Scholar
6.Fitzgerald, G. Emergency department triage. Queensland (AU): University of Queensland; 1989.Google Scholar
7.Manchester Triage Group. Emergency triage. Plymouth (UK): BMJ Publishing Group; 1997.Google Scholar
8.Gilboy, N, Tanabe, P, Travers, DA, et al.Emergency Severity Index version 4: implementation handbook. Rockville (MD): AHRQ Publication; 2005.Google Scholar
9.Warren, DW, Jarvis, A, LeBlanc, L, et al.Revisions to the Canadian Triage and Acuity Scale Paediatric Guidelines (PaedCTAS). CJEM 2008;10:224–32.CrossRefGoogle Scholar
10.Gravel, J, Gouin, S, Bailey, B, et al.Reliability of a computerized version of the Pediatric Canadian Triage and Acuity Scale. Acad Emerg Med 2007;14:864–9.CrossRefGoogle ScholarPubMed
11.Last, JM. A dictionary of epidemiology. 4th ed. Oxford (UK): Oxford University Press; 2001.Google Scholar
12.Bergeron, S, Gouin, S, Bailey, B, et al.Comparison of triage assessments among pediatric registered nurses and pediatric emergency physicians. Acad Emerg Med 2002;9:1397–401.CrossRefGoogle ScholarPubMed
13.Bergeron, S, Gouin, S, Bailey, B, et al.Agreement among pediatric health care professionals with the pediatric Canadian Triage and Acuity Scale guidelines. Pediatr Emerg Care 2004;20:514–8.Google Scholar
14.Dong, SL, Bullard, MJ, Meurer, DP, et al.Emergency triage: comparing a novel computer triage program with standard triage. Acad Emerg Med 2005;12:502–7.Google Scholar
15.Roukema, J, Steyerberg, EW, van Meurs, A, et al.Validity of the Manchester Triage System in paediatric emergency care. Emerg Med J 2006;23:906–10.CrossRefGoogle ScholarPubMed
16.Gouin, S, Gravel, J, Amre, DK, et al.Evaluation of the Paediatric Canadian Triage and Acuity Scale in a pediatric ED. Am J Emerg Med 2005;23:243–7.Google Scholar
17.Jarvis, DA, Goldman, RD. Paediatric Canadian Triage and Acuity Scale as a predictor for outcome and resource utilization. CJEM 2007;9.Google Scholar
18.Dong, SL, Bullard, MJ, Meurer, DP, et al.Predictive validity of a computerized emergency triage tool. Acad Emerg Med 2007;14:16–21.Google Scholar
19.Baumann, MR, Strout, TD. Evaluation of the Emergency Severity Index (version 3) triage algorithm in pediatric patients. Acad Emerg Med 2005;12:219–24.CrossRefGoogle ScholarPubMed