The Manchester triage system: improvements for paediatric emergency care
| Autor: | Johan van der Lei, Mirjam van Veen, Alfred H J van Meurs, Henriëtte A. Moll, Madelon Ruige, Mariët van't Klooster, Ewout W. Steyerberg |
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| Přispěvatelé: | Pediatrics, Public Health, Medical Informatics |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Vital signs Psychological intervention Critical Care and Intensive Care Medicine Pediatrics Sensitivity and Specificity Teaching hospital Medicine Humans Prospective Studies Child Reference standards Netherlands business.industry Infant General Medicine Triage Pediatric Nursing Child Preschool Emergency medicine Emergency Medicine Observational study Female business Emergency Service Hospital Paediatric emergency |
| Zdroj: | Emergency Medicine Journal, 29(8), 654-659. BMJ Publishing Group |
| ISSN: | 1472-0213 1472-0205 |
| Popis: | Objective To improve the Manchester Triage System (MTS) in paediatric emergency care. Methods The authors performed a prospective observational study at the emergency departments of a university and teaching hospital in The Netherlands and included children attending in 2007 and 2008. The authors developed and implemented specific age-dependent modifications for the MTS, based on patient groups where the system9s performance was low. Nurses applied the modified system in 11 481 (84%) patients. The reference standard for urgency defined five levels based on a combination of vital signs at presentation, potentially life-threatening conditions, diagnostic resources, therapeutic interventions and follow-up. The reference standard for urgency was previously defined and available in 11 260/11 481 (96%) patients. Results Compared with the original MTS specificity improved from 79% (95% CI 79% to 80%) to 87% (95% CI 86% to 87%) while sensitivity remained similar ((63%, 95% CI 59% to 66%) vs (64%, 95% CI 60% to 68%)). The diagnostic OR increased (4.1 vs 11). Conclusions Modifications of the MTS for paediatric emergency care resulted in an improved specificity while sensitivity remained unchanged. Further research should focus on the improvement of sensitivity. |
| Databáze: | OpenAIRE |
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