The accuracy of the pediatric assessment triangle in assessing triage of critically ill patients in emergency pediatric department
Section snippets
Background
The number of newborn babies in China is increasing, and it is estimated that it will reach 1 to 2 million every year [1]. A survey on the development status of pediatrics in the tertiary grade A hospital in Guangzhou showed that the number of emergency pediatrics from 2012 to 2016 is on the rise, and the number of hospital visits has significantly increased, much faster than an increase in pediatric medical staff [2]. We investigated the visits to the emergency department of Kunshan First
Study design and setting
This was a prospective observational study in which we analyzed a cohort of children attending the EPD of a tertiary general hospital in China during a period of 5 months (January to May 2019). The study was approved by the ethics committee of The First People’s Hospital of Kunshan (No.2018-08-L002). Considering the urgency of the child’s condition and the innocuous nature of the PAT assessment of the condition, the informed consent form was signed after triage. After critical group entered the
Result
A total of 1636 children attended the EPD during the study period. Twenty-eight (1.7%) patients were excluded for refusing to participate in the study. The final analysis was based on 1608 patients’ data. There were 897 (55.78%) male, 844(52.49%) children aged 1 to 36 months, and 1319 (82.03%) children with respiratory diseases. Age range was 1 month to 14 years. Baseline characteristics are summarized in Table 1.
There were 74 critically ill children in total and 1534 non-critically ill
Discussion
Among the 1608 subjects recruited in this study, the male to female ratio was 1.26:1, which is consistent with the ratio (1.168:1) of the sixth census in China in 2010 [30]. The top five diseases in emergency pediatrics were respiratory diseases (82.03%), digestive diseases (10.57%), neurological diseases (3.61%), infectious diseases (2.80%), and accidental injuries of children (0.68%). Respiratory diseases were mainly airway infection and bronchial pneumonia; digestive diseases were mainly
Limitations
There were some limitations in this study. Firstly, only the ill children visiting emergency pediatric medical were included in this study, and the next step we will explore the effectiveness of PAT in emergency pediatric surgery children and children with diseases other than respiratory system. Secondly, the nurses’ acceptance in this study was investigated only in the outpatient and emergency room of the studied hospital. Whether it is applicable to other hospitals requires further clinical
Conclusion
- (1)
PAT can be used as an assessment tool for rapid screening of the severity of children in the emergency department in China;
- (2)
When the PAT score is more than or equal to 1 point, the child can be predicted to be critically ill and give priority to treatment;
- (3)
PAT is easily accepted by triage nurses in the emergency room, so this tool can be used as a quick and effective disease assessment tool in emergency pediatrics.
CRediT authorship contribution statement
Xiaomin Ma: Conceptualization, Data curation, Formal analysis. Yuanyuan Liu: Formal analysis, Writing - original draft. Mingqing Du: Investigation. Omorogieva Ojo: Writing - review & editing. Lijuan Huang: Investigation. Xiaohua Feng: Investigation. Qiong Gao: Investigation. Xiaohua Wang: Supervision, Writing - review & editing.
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Cited by (0)
- 1
Xiaomin Ma and Yuanyuan Liu are co-first authors.