Triage of Children at the Emergency Department: Manchester Triage System or Pediatric Early Warning Score?

NCT ID: NCT02094404

Last Updated: 2015-05-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

727 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-12-31

Study Completion Date

2014-03-31

Brief Summary

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Currently, the Manchester Triage System (MTS) is used to triage all children presenting at the emergency department(ED) in this hospital. This system has been proven safe, but many patients are classified as too urgent. In this hospital adults are prioritised at the ED by a score based on vital signs, the early warning score. A similar score is developed suitable for children. This score, the Pediatric Early Warning Score (PEWS), is already used to determine clinical deterioration.

The investigators hypothesize that children can be triaged safely with the PEWS.

If it is safe, there will be one triage system again at the ED. Another advantage will be more continuity in assessing the condition of patients who are admitted to the hospital.

Detailed Description

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Background: Triage systems are used at EDs to prioritize patients to make sure that those who need it, receive immediate care.

The MTS is used for children at EDs by many hospitals worldwide, also at the ED of the Isala, the Netherlands. This triage system has been proven safe, but many patients are classified as too urgent. This is a disadvantage because accurate triage is needed to provide access for immediate ill patients and for sufficient flow at the ED.

Currently, adult patients at the ED of the Isala are classified by the early warning score. This is a score based on vital signs and it is easily calculated. It originally has been developed to determine clinical deterioration. For children normal values are different for each age. Therefore there has been developed the PEWS, which is now only used to evaluate clinical patients. Ideally for the continuity in this hospital, there would be one system which can be used for triage as well as for clinical patients. The investigators hypothesize that the PEWS is a safe alternative for the triage of children at the ED.

Design: A form will be attached on the file of all children presenting at the ED, for recording data. These forms will be collected afterwards. The emergency department nurses will record the vital signs, which the investigators need to calculate the PEWS as well as the urgency determined by the MTS for each patient. The expert opinion will also be recorded. This is de urgency according to the doctor who has seen the patient, maximal acceptable door-to-doctor time: very urgent (immediate), urgent (\<15minutes) or normal (\<1hour). At the end of the consultation at the ED, the reference standard will be determined for each patient independent of MTS urgency or PEWS, with data available from the patient file. (1) For secondary outcome measures may or may not hospital admission or intensive care admission will be recorded.

No interventions are made and this study is of no influence on the treatment of the patients.

Conditions

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Triage of Children

Keywords

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Emergency Department Pediatric Early Warning Score Manchester Triage System

Study Design

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Study Time Perspective

PROSPECTIVE

Study Groups

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Children at the ED<18yr

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* All children presenting at the Emergency Department of the Isala.

Exclusion Criteria

* Children seen in room 17, the plaster and little trauma room (because of practical reasons).
Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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E.P. de Groot

OTHER

Sponsor Role lead

Responsible Party

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E.P. de Groot

MD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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E.P de Groot, MD

Role: PRINCIPAL_INVESTIGATOR

Isala

Locations

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Isala

Zwolle, Overijssel, Netherlands

Site Status

Countries

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Netherlands

References

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van Veen M, Steyerberg EW, Ruige M, van Meurs AH, Roukema J, van der Lei J, Moll HA. Manchester triage system in paediatric emergency care: prospective observational study. BMJ. 2008 Sep 22;337:a1501. doi: 10.1136/bmj.a1501.

Reference Type BACKGROUND
PMID: 18809587 (View on PubMed)

Other Identifiers

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KSEH13

Identifier Type: -

Identifier Source: org_study_id