儿科重大事件初级分诊工具的比较
Comparison of paediatric major incident primary triage tools.
作者信息
Wallis L A, Carley S
机构信息
Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa.
出版信息
Emerg Med J. 2006 Jun;23(6):475-8. doi: 10.1136/emj.2005.032672.
OBJECTIVES
To determine the sensitivity and specificity of paediatric major incident triage scores. The Paediatric Triage Tape (PTT), Careflight, Simple Triage and Rapid Treatment (START), and JumpSTART systems were tested.
METHODS
In total, 3461 children presenting to a South African emergency department with trauma were scored using the four different methods. The sensitivity and specificity of the four scores was calculated against the Injury Severity Score (ISS), New ISS (NISS), and a modification of the Garner criteria (a measure of need for urgent clinical intervention). We also performed a Bayesian analysis of the scores against three different types of major incident.
RESULTS
None of the tools showed high sensitivity and specificity. Overall, the Careflight score had the best performance in terms of sensitivity and specificity. The performance of the PTT was very similar. In contrast, the JumpSTART and START scores had very low sensitivities, which meant that they failed to identify patients with serious injury, and would have missed the majority of seriously injured casualties in the models of major incidents.
CONCLUSION
The Careflight or PTT methods of triage should be used in paediatric major incidents in preference to the jumpSTART or START methods.
目的
确定儿科重大事件分诊评分的敏感性和特异性。对儿科分诊胶带（PTT）、Careflight、简单分诊与快速治疗（START）以及JumpSTART系统进行了测试。
方法
总共对3461名因创伤前往南非急诊科就诊的儿童使用四种不同方法进行评分。根据损伤严重度评分（ISS）、新损伤严重度评分（NISS）以及加纳标准的一种修改版本（衡量紧急临床干预需求的指标）计算这四种评分的敏感性和特异性。我们还针对三种不同类型的重大事件对这些评分进行了贝叶斯分析。
结果
没有一种工具显示出高敏感性和特异性。总体而言，Careflight评分在敏感性和特异性方面表现最佳。PTT的表现非常相似。相比之下，JumpSTART和START评分的敏感性非常低，这意味着它们未能识别出重伤患者，并且在重大事件模型中会遗漏大多数重伤伤员。
结论
在儿科重大事件中，应优先使用Careflight或PTT分诊方法，而不是JumpSTART或START方法。
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