The accuracy of existing prehospital triage tools for injured children in England: an analysis using emergency department data.
OBJECTIVE
To investigate the performance characteristics in children with moderate and minor injuries of prehospital paediatric triage tools currently in use in England for identifying seriously injured children.


METHODS
Eight prehospital paediatric triage tools were identified from literature review and a survey of the lead trauma clinicians across the 10 English strategic health authorities. Retrospective clinical data from 2934 patient records collected by four emergency departments were used to analyse each tool. A target sensitivity of >95% and specificity of 50-75% was set based on the literature.


RESULTS
Three tools (East Midlands, North West and Northern) demonstrated acceptable sensitivity (all 100%). The other five tools fell below the target sensitivity of >95%. All eight tools had acceptable specificity (with results between 79% and 99%).


CONCLUSIONS
Three tools (East Midlands, North West and Northern) demonstrated acceptable over- and under-triage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage.
['Ardolino|Antonella|A|', 'Cheung|C Ronny|CR|', 'Lawrence|Thomas|T|', 'Bouamra|Omar|O|', 'Lecky|Fiona|F|', 'Berry|Kathleen|K|', 'Lyttle|Mark|M|', 'Roland|Damian|D|', 'Koralage|Nadeeja|N|', 'Issa|Shabara|S|', 'Chaudhary|Adeel|A|', 'Maconochie|Ian|I|', '|||']
D000293:Adolescent D002648:Child D002675:Child, Preschool D004632:Emergency Medical Services D004636:Emergency Service, Hospital D004739:England D006801:Humans D007223:Infant D007231:Infant, Newborn D015601:Injury Severity Score D016013:Likelihood Functions D011237:Predictive Value of Tests D012189:Retrospective Studies D012680:Sensitivity and Specificity D014218:Triage D014947:Wounds and Injuries
Emergency Department Trauma Major Trauma Management Paediatric Injury Pre-Hospital