Triage van kinderen op de Spoedeisende Hulp: de Pediatric Early Warning Score als triagesysteem?

Bekkum, M. van (2014) Triage van kinderen op de Spoedeisende Hulp: de Pediatric Early Warning Score als triagesysteem? thesis, Medicine.

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Abstract

Introduction: Adequate triage systems are necessary at an Emergency Departments (ED) to identify those who are in need of immediate care. But, overtriage should be prevented, because of limited capacity of the ED and increasing waiting times for the urgently sick. Currently, the Manchester Triage System (MTS) is used for triage of children. This system has been proven safe, but leads to considerable overtriage. A possible solution would be to perform triage with the Pediatric Early Warning Score (PEWS). This score, existing of several physiological parameters, is used at pediatric wards for detection of early clinical deterioration. This would also have the advantage of only one triage system at the ED. Objective: Examining the PEWS as triage method for pediatric patients at the ED, by comparing the MTS and PEWS with an independent reference standard. Methods: All patients under the age of 18 years, except for those with minor trauma, presenting themselves at the ED were included. The parameters of the PEWS were measured and recorded and calculated subsequently. The reference standard has been used for validation of the MTS with children. The urgency according to the reference standard was determined with information derived from the patient file. The PEWS and the MTS were compared to the reference standard for three triage levels: immediate, urgent and normal. Results: Data of 696 patients were analyzed. The PEWS had a range from 0-19. The urgency levels were defined: ≥10 (immediate), 8-9 (<15minutes) and 0-7 (<1hour). The MTS agreed in 77% with urgency according to the reference standard, with 7,8% ondertriage and 16% overtriage. The PEWS agreed in 86%, with 6,8% ondertriage and 6,8% overtriage. Conclusions: The PEWS provided more properly triage, comparable ondertriage and less overtriage than the MTS. The PEWS with 3 urgency levels seems to be a safe method for triage of children at the ED.

Item Type:	Thesis (Thesis)
Supervisor name:	Groot, Dhr. E.P. de and Veldhuis, Dhr. J.G. and Isala te Zwolle
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1960

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