Problems with and improvements for triaging pediatric surgery patients.

Summary of "Problems with and improvements for triaging pediatric surgery patients."

Background:  The Canadian Paediatric Triage and Acuity Scale (P-CTAS) is used and modified at hospitals as a triage tool for pediatric patients before they are seen in emergency rooms. Pediatric surgery patients account for very few of the many patients in emergency departments, but they should be triaged as "emergent or urgent" because they might be candidates for surgery. Problems with and improvements for triaging pediatric surgery patients using the P-CTAS were studied. Methods:  This retrospective study evaluated all patients less than 16 years old who visited the emergency department of Kyorin University Hospital during an approximately 4-year period between May 1, 2005, and February 11, 2009. Pediatric surgery patients were divided in two groups to evaluate the efficiency of P-CTAS triage. Patients who needed emergency treatment were in Group A, and the others were in Group B. Results:  Most Group A patients were level I, II, or III (97%, 111/114). On the other hand, the middle of Group B patients was level IV. Some problems with and suggestions for the P-CTAS were identified. They were many patients with trauma under one year of age, and many with a foreign body were under two years of age. Age categories should be added for patients with trauma or foreign body aspiration. Patients with abdominal pain, and without anal bleeding or vomiting over two years old are triaged as level IV and they accounted for 12% of patients of possible intussusception in this study. A category of "possible intussusception" should be made for level II. Most patients with acute scrotum, whether operated or not, were level III. "Red or purple color of scrotal skin" and/or "within 6 hours from onset" could be added to level II for patients with acute scrotum. Conclusions:  P-CTAS worked quite well for pediatric surgery patients, and it needs to be modified and improved for such patients based on these results. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

Affiliation

Department of Pediatric Surgery, Kyorin University Faculty of Medicine, Tokyo, Japan Department of Pediatric Surgery, International University of Health and Welfare, Atami Hospital, Shizuoka, Japan.

Journal Details

This article was published in the following journal.

Name: Pediatrics international : official journal of the Japan Pediatric Society
ISSN: 1442-200X
Pages:

Links

• PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22621411
• DOI: http://dx.doi.org/10.1111/j.1442-200X.2012.03669.x