Pediatric Triage: A Review of Emergency Education Literature (original) (raw)

C hildren represent about a fourth of the population treated each year in US hospital emergency departments. 1 This means that approximately 30 million children enter the emergency health care system and undergo a triage assessment by a nurse. Pediatric triage involves rapid recognition of seriously ill or injured children, assigning an acuity rating level, and anticipating appropriate emergency care and referral. Acuity rating levels are used to prioritize patients for care and typically involve assigning a numeric score to patients, such as level 1 (most acute) to level 5 (least acute). Although no standard system for triage acuity rating exists in the United States, ENA and the American College of Emergency Physicians have recommended that emergency departments use a valid, reliable 5-level acuity system. 2 Two such systems are the Emergency Severity Index (ESI) and the Canadian Triage and Acuity Scale (CTAS). Both systems recommend that triage nurses undergo general triage education in addition to acuity system-specific education. Furthermore, ENA and the ESI and CTAS materials recommend that triage be performed only by experienced ED nurses. Children often present with subtle signs and symptoms of illnesses and injuries, and emergency nurses must possess strong pediatric assessment skills to perform prompt, accurate triage of children. The pediatric triage process is critically important and may even warrant recognition as a specialty within emergency nursing. Yet, with the exception of a few programs, current pediatric emergency education resources include only a brief definition of what it is rather than on how to actually do it. Courses that have some focus on pediatric triage often are limited to describing specific disease states or categories such as trauma or medical resuscitation.