Department of Emergency Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
BMC Health Serv Res. 2022 Sep 12;22(1):1154. doi: 10.1186/s12913-022-08528-8.
We aimed to establish simplified and quantifiable triage criteria in pediatric emergency care, improving the efficiency of pediatric emergency triage and ensuring patient safety.
We preliminarily determined the pediatric emergency triage criteria with references to pediatric emergency department characteristics and internationally recognized triage tools after literature review and discussion. The final determination of the triage criteria was reached after two rounds of Delphi surveys completed by18 experts from 3 hospitals in China.
Both round 1 and round 2 surveys had a 100% response rate. The overall expert authority coefficient in the two rounds of surveys was 0.872. The experts had 100% enthusiasm for participating in the surveys. Kendall's coefficients of concordance for conditions/symptoms in patients triaged to level 1, 2, 3, and 4 were 0.149, 0.193, 0.102, and 0.266, respectively. All p-values were less than 0.05. The coefficients of variation in conditions/symptoms, vital signs, and the Pediatric Early Warning Score (PEWS) ranged between 0.00 and 0.205, meeting the inclusion criteria. The pediatric emergency triage criteria containing conditions/symptoms, vital signs, PEWS scores, and other 4 level 1 indicators, 51 level 2 indicators and 23 level 3 indicators were built. The maximum waiting time to treatment for the patients triaged to level 1, 2, 3, and 4 was immediate, within 10 min, within 30 min, and within 240 min, respectively.
The pediatric emergency triage criteria established in this study was scientific and reliable. It can be used to quickly identify the patients requiring urgent and immediate care, thereby ensuring the priorities for the care of critically ill patients.
本研究旨在建立简化且可量化的儿科急诊分诊标准，以提高儿科急诊分诊效率，保障患者安全。
通过文献回顾和讨论，参考儿科急诊特点和国际认可的分诊工具初步确定儿科急诊分诊标准。然后通过 3 家医院的 18 位专家进行两轮德尔菲调查，最终确定了分诊标准。
两轮调查的回复率均为 100%。两轮调查的专家权威系数均为 0.872。专家参与两轮调查的积极性均为 100%。1 级、2 级、3 级和 4 级患儿的症状/体征进行分层时，Kendall 协调系数分别为 0.149、0.193、0.102 和 0.266，均 P<0.05。症状/体征、生命体征和儿童早期预警评分（PEWS）的变异系数为 0.00～0.205，均符合纳入标准。本研究构建了包含症状/体征、生命体征、PEWS 评分和其他 4 个 1 级指标、51 个 2 级指标、23 个 3 级指标的儿科急诊分诊标准。1 级、2 级、3 级和 4 级患者的预计治疗等待时间分别为即刻、10 min 内、30 min 内和 240 min 内。
本研究建立的儿科急诊分诊标准科学可靠，能快速识别出需要紧急救治的患者，保证了危重症患者的救治优先级。
