Wallis L A, Carley S
Red Cross Children's Hospital, Cape Town, South Africa.
Emerg Med J. 2006 Jan;23(1):47-50. doi: 10.1136/emj.2005.024893.
The Paediatric Triage Tape (PTT) is an easy to use major incident primary triage tool, based upon a modification of the Triage Sieve. The purpose of this study was to prospectively validate the PTT for use in paediatric major incidents.
A database of children presenting the Trauma Unit of the Red Cross Children's Hospital, Cape Town, was developed over a nine month period. Each child was triaged using the PTT, and had an Injury Severity Score (ISS) calculated. Additionally, the New Injury Severity Score (NISS) was calculated, and the presence of interventions that may occur to the children ("Garner criteria") was documented. The sensitivity, specificity, overtriage, and undertriage rates were calculated.
3461 children were entered into the database. For identifying children with an ISS of over 15, the PTT had a sensitivity of 37.8%, specificity of 98.6%, overtriage rate of 38.8%, and an undertriage rate of 3.5%. Against the NISS and Garner criteria, the results were comparable.
The PTT has poor sensitivity at identifying immediate priority children by these criteria. Specificity (the ability to identify non-T1 patients) is excellent, and the overtriage and undertriage rates are within the range deemed unavoidable by the American College of Surgeons.
儿科分诊胶带(PTT)是一种易于使用的重大事件初级分诊工具,它是对分诊筛检法进行改良后得到的。本研究的目的是对PTT在儿科重大事件中的应用进行前瞻性验证。
在九个月的时间里,建立了一个关于开普敦红十字儿童医院创伤科就诊儿童的数据库。每个儿童都使用PTT进行分诊,并计算损伤严重度评分(ISS)。此外,还计算了新损伤严重度评分(NISS),并记录了儿童可能接受的干预措施(“加纳标准”)。计算了敏感度、特异度、过度分诊率和漏分诊率。
3461名儿童被纳入数据库。对于识别ISS超过15分的儿童,PTT的敏感度为37.8%,特异度为98.6%,过度分诊率为38.8%,漏分诊率为3.5%。与NISS和加纳标准相比,结果相当。
按照这些标准,PTT在识别急需优先处理的儿童方面敏感度较差。特异度(识别非T1患者的能力)极佳,过度分诊率和漏分诊率在美国外科医师学会认为不可避免的范围内。