04 April 2024 : Clinical Research
Outcomes of Chengdu Pediatric Emergency Triage Criteria: A Retrospective Study of 198,628 Pediatric Patient Records
Jing Zhao12BCE, Yingying Zhao12BC, Juan Hu12ABCEG*, Yan Huang12BE, Liqing He12BDOI: 10.12659/MSM.942814
Med Sci Monit 2024; 30:e942814
Table 1 Chengdu pediatric emergency triage criteria.
| Triage levels | Indicators | Description | Value | Maximum waiting time for treatment |
|---|---|---|---|---|
| Level 1 | Conditions/symptoms (critical) | Sudden cardiac arrest, respiratory arrest; Airway obstruction or asphyxia; Emergency endotracheal intubation/tracheotomy is required; Signs of shock; Sudden loss of consciousness; Signs of cerebral hernia; Life-threatening acute poisoning; Precipitously birth (umbilical cord was not cut or Apgar score <3); Complex or multiple trauma; Most severe or large burns; Ocular trauma with eyeball injury | Immediate | |
| Vital signs | Temperature (°C)Oxygen saturation (SpO2)AVPU (alert, verbal, pain, unresponsive) scale | ≤35 or ≥41<90%U | ||
| Pediatric Early Warning Score (PEWS) Score | PEWS ≥5 | |||
| Other | The triage nurse believed that the patients was encountering a life-threatening situation and requiring emergency care | |||
| Level 2 | Conditions/symptoms (high risk) | Chest distress, chest pain, heart palpitations, stable vital signs, high risk or potential risk; Status epilepsy; Convulsion; Diabetic ketoacidosis; Acute asthma with stable blood pressure and pulse rate; Capillary refill time ≥3s; Low reaction to mental state and high level of irritability; Hypersomnia (able to wake up; fall asleep without stimuli) with unstable vital signs; Newborns with temperature of >38°C; Acute poisoning but does not meet level 1 criteria; Sudden change in consciousness; Incomplete airway obstruction; Esophageal foreign body; Severe anemia (no active bleeding) 30–60 g/L; Abdominal pain (suspected strangulated intestinal obstruction, incarcerated hernia, intussusception, gastrointestinal perforation, or urinary tract calculi) with the pain score >6; Osteofascial compartment syndrome; Active bleeding (epistaxis, hematuria, hematochezia, hemoptysis, or hematemesis) with unstable vital signs | <10 min | |
| Vital signs | Pulse rate (beats/min) | P>180 (y<3 months old);P>160 (3 months old ≤y<3 years old);P>140 (3 years old ≤y<8 years old);P>100 (y≥8 years old) | ||
| Respiration rate (breaths/min) | R>50 (y<3 months old);R>40 (3 months old ≤y<3 years old);R>30 (3 years old ≤y<8 years old);R>20 (y≥8 years old) | |||
| SpO2 | 90–92% | |||
| Level 2 | Vital signs | Systolic blood pressure | >130 mmHg (≥5 years old) or <75 mmHg (≥5 years old) | |
| PEWS score | PEWS=3–4 | |||
| Other | The triage nurse believed that the patients was at a high-risk situation or potential risk but required no emergency care | |||
| Level 3 | Conditions/ symptoms | Intermittent epileptic seizures; With a history of hyperpyretic convulsion; Foreign body aspiration but no breathing difficulty; Dysphagia but no breathing difficulty; Mental and behavior disorder; Severe vomiting; Symptoms of allergic reaction (obvious rashes on the skin and mucous membranes, extensive facial swelling, etc.); Hypersomnia (able to wake up; fall asleep without stimuli) with stable vital signs; Moderate to severe pain with any cause (score: 4–6); Stable newborns; Active bleeding (epistaxis, hematuria, hematochezia, hemoptysis, or hematemesis) with stable vital signs; Unexplained abdominal distension with mental malaise; Mucocutaneous hemorrhage/platelet ≤20×10/L | <30 min | |
| Vital signs | Pulse rate (beats/min) | 88 | ||
| Respiration rate (breaths/min) | 24 | |||
| PEWS score | PEWS=1–2 | |||
| Other | The pediatric patient had acute symptoms and emergency issues | |||
| Level 4 | Conditions/ symptoms | Vomiting or diarrhea without dehydration; Mild pain | <240 min | |
| PEWS score | PEWS=0 | |||
| Other | Mild or non-urgent condition |