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The accuracy of existing prehospital triage tools for injured children in England: an analysis using emergency department data
  1. Antonella Ardolino1,
  2. C Ronny Cheung2,
  3. Thomas Lawrence3,
  4. Omar Bouamra3,
  5. Fiona Lecky4,5,
  6. Kathleen Berry6,
  7. Mark Lyttle7,
  8. Damian Roland8,
  9. Nadeeja Koralage9,
  10. Shabara Issa9,
  11. Adeel Chaudhary10,
  12. Ian Maconochie10,
  13. on behalf of the PERUKI group
  1. 1Royal Hampshire Hospital, Winchester, UK
  2. 2Department of Paediatrics, St Thomas’ Hospital, London, UK
  3. 3The Trauma Audit and Research Network, University of Manchester, Hope Hospital, Salford, UK
  4. 4University of Manchester/Salford Royal Hospital, Salford, UK
  5. 5Health Services Research Group, School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
  6. 6Birmingham Children's Hospital, Birmingham, UK
  7. 7Bristol Royal Hospital for Children, Bristol, UK
  8. 8University of Leicester, Leicester, UK
  9. 9St Marys Hospital, Imperial College NHS Healthcare Trust, London, UK
  10. 10Leicester Royal Infirmary, Leicester, UK
  1. Correspondence to A Ardolino, Sandhill, Poles Lane, Otterbourne, Winchester, UK SO21 2DZ; tonia{at}entee.co.uk, toni.a{at}doctors.org.uk

Abstract

Objective To investigate the performance characteristics in children with moderate and minor injuries of prehospital paediatric triage tools currently in use in England for identifying seriously injured children.

Methods Eight prehospital paediatric triage tools were identified from literature review and a survey of the lead trauma clinicians across the 10 English strategic health authorities. Retrospective clinical data from 2934 patient records collected by four emergency departments were used to analyse each tool. A target sensitivity of >95% and specificity of 50–75% was set based on the literature.

Results Three tools (East Midlands, North West and Northern) demonstrated acceptable sensitivity (all 100%). The other five tools fell below the target sensitivity of >95%. All eight tools had acceptable specificity (with results between 79% and 99%).

Conclusions Three tools (East Midlands, North West and Northern) demonstrated acceptable over- and under-triage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage.

  • Trauma
  • Emergency Department
  • Major Trauma Management
  • Paediatric Injury
  • Pre-Hospital

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