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Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale

Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatri...

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Autores principales: Lee, Bongjin, Kim, Do Kyun, Park, June Dong, Kwak, Young Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592187/
https://www.ncbi.nlm.nih.gov/pubmed/28875617
http://dx.doi.org/10.3346/jkms.2017.32.10.1702
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author Lee, Bongjin
Kim, Do Kyun
Park, June Dong
Kwak, Young Ho
author_facet Lee, Bongjin
Kim, Do Kyun
Park, June Dong
Kwak, Young Ho
author_sort Lee, Bongjin
collection PubMed
description Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatric Korean Triage and Acuity Scale (PedKTAS) has been used nationwide for triage since 2016. The triage level, as assessed by an experienced triage nurse and based on the patient's clinical condition, was defined as the ‘real practice (RP)-level,’ while the re-calculated triage level, as assessed by the direct application of initial vital signs, was defined as the ‘simulation (S)-level.’ A total of 22,841 patients were triaged during the study period. The hospitalization rate according to RP-PedKTAS levels exhibited a significant correlation with the expected hospitalization rate suggested by the Pediatric Canadian Triage and Acuity Scale (CTAS) (P = 0.002), whereas the S-PedKTAS levels did not (P = 0.151). Compared with the previously reported pediatric CTAS level-specific hospitalization rate and intensive care unit (ICU) admission rate, RP-PedKTAS was significantly correlated with both hospitalization rate and ICU admission rate (P = 0.001 and P = 0.012, respectively). However, S-PedKTAS showed no significant correlation in both (P = 0.267 and P = 0.188, respectively). The determination of triage levels based on clinical decision rather than the direct application of abnormal initial vital signs to PedKTAS is more accurate in predicting the hospitalization rate and ICU admission rate.
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spelling pubmed-55921872017-10-01 Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale Lee, Bongjin Kim, Do Kyun Park, June Dong Kwak, Young Ho J Korean Med Sci Original Article Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatric Korean Triage and Acuity Scale (PedKTAS) has been used nationwide for triage since 2016. The triage level, as assessed by an experienced triage nurse and based on the patient's clinical condition, was defined as the ‘real practice (RP)-level,’ while the re-calculated triage level, as assessed by the direct application of initial vital signs, was defined as the ‘simulation (S)-level.’ A total of 22,841 patients were triaged during the study period. The hospitalization rate according to RP-PedKTAS levels exhibited a significant correlation with the expected hospitalization rate suggested by the Pediatric Canadian Triage and Acuity Scale (CTAS) (P = 0.002), whereas the S-PedKTAS levels did not (P = 0.151). Compared with the previously reported pediatric CTAS level-specific hospitalization rate and intensive care unit (ICU) admission rate, RP-PedKTAS was significantly correlated with both hospitalization rate and ICU admission rate (P = 0.001 and P = 0.012, respectively). However, S-PedKTAS showed no significant correlation in both (P = 0.267 and P = 0.188, respectively). The determination of triage levels based on clinical decision rather than the direct application of abnormal initial vital signs to PedKTAS is more accurate in predicting the hospitalization rate and ICU admission rate. The Korean Academy of Medical Sciences 2017-10 2017-08-28 /pmc/articles/PMC5592187/ /pubmed/28875617 http://dx.doi.org/10.3346/jkms.2017.32.10.1702 Text en © 2017 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Bongjin
Kim, Do Kyun
Park, June Dong
Kwak, Young Ho
Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale
title Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale
title_full Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale
title_fullStr Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale
title_full_unstemmed Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale
title_short Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale
title_sort clinical considerations when applying vital signs in pediatric korean triage and acuity scale
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592187/
https://www.ncbi.nlm.nih.gov/pubmed/28875617
http://dx.doi.org/10.3346/jkms.2017.32.10.1702
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