The accuracy of existing prehospital triage tools for injured children in England: An analysis using emergency department data

Ardolino, Antonella; Cheung, C. Ronny; Lawrence, Thomas; Bouamra, Omar; Lecky, Fiona; Berry, Kathleen; Lyttle, Mark; Roland, Damian; Koralage, Nadeeja; Issa, Shabara; Chaudhary, Adeel; Maconochie, Ian

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 undertriage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage.

• Journal Article Type: Article
• Publication Date: May 1, 2015
• Journal: Emergency Medicine Journal
• Print ISSN: 1472-0205
• Electronic ISSN: 1472-0213
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 5
• Pages: 397-400
• DOI: https://doi.org/10.1136/emermed-2013-203251
• Keywords: accuracy, prehospital triage tools, children, England, emergency department
• Public URL: https://uwe-repository.worktribe.com/output/834811
• Publisher URL: http://dx.doi.org/10.1136/emermed-2013-203251