Dijk, B. van (Birgit) (2016) MTS versus PWS ; validatie van de PEWS als triagesysteem voor pediatrische Spoedeisende Hulp. thesis, Medicine.
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Abstract
Background: On the emergency department (ED), it is important to have a triage system that divides the patients into different groups of urgency. To distinguish between patients that require immediate assistance and patients who can wait safely. Overtriage must be prevented, so that there does not occur unnecessary waiting times for urgent patients. Nowadays the Manchester Triage System (MTS) is used for children. This is a secure system but gives much overtriage. The Paediatric Early Warning Score (PEWS) is a score of physiological parameters and is currently used in the pediatric ward. Therefore, by validating the PEWS, clinical deterioration is recognized earlier. A similar triage system is used for adults in the ED, thus there would be uniform system originated in the ED. Objective: To determine if the PEWS is suitable as a triage method for children in the ED. Methods: All patients under the age of 18 years visiting the ED, with the exception of minor trauma, were included. The primarily triage method used was the MTS, in addition the parameters of the PEWS were recorded. Both systems were compared with an independent reference standard. The results of the MTS and PEWS were divided in five, four and three urgency categories. Results: Data of 905 patiënts were analyzed. When the results of the triage methods were divided in three categories, the MTS managed in 80.8% to triage correctly (88.1% at the PEWS), a undertriage of 5.9% (PEWS 6.4%) and a overtriage of 13, 4% (PEWS 5.5%). In the four categories of urgency the MTS came to 50.9% in line with the reference standard (PEWS to 51.7%) , in 12.4% of all patients there was undertriage (PEWS 14.7%) and 36.7% overtriage (PEWS 33.6%). Conclusion: Triage with the PEWS in three urgency categories gives significant more accurate triage and significant less overtriage, with comparable undertriage compared to the MTS. Triage with the PEWS in four urgency categories gives compareble accurate triage and overtriage with a bit more undertriage compared to the MTS.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Groot, Drs. E.P. de and Locatie: Isala te Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/464 |
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