title: Triage assessment in pediatric emergency departments: a national survey.
abstract: OBJECTIVE
  Because of the varying physiological and developmental stages in children, the taking of vital signs and other assessments at triage in an emergency department (ED) can be challenging. The purpose of this study was to examine current triage practices in pediatric EDs in the United States.
  
  
  METHODS
  A mailed survey was sent in August 2006 to the medical directors of the 99 pediatric EDs listed on the National Association of Children's Hospitals and Related Institutions Web site, with follow-up mailing in October 2006 and subsequent phone contact.
  
  
  RESULTS
  Eighty-eight surveys were returned (90% response rate). When asked what assessments are done on all patients at triage, all EDs (100%) obtain pulse rate and respiratory rate, 92% measure temperature, 60% measure blood pressure, 41% measure pulse oximetry, and 13% assess Glasgow Coma Scale. The methods used to measure temperature were widely variable. Multiple methods are used to assess pain: for those aged 0 to 2 years, 44% use a Wong FACES Scale and 48% use a behavioral scale; at 2 to 4 years, most (80%) use the Wong FACES Scale, but in older 10- to 18-year-old patients, most (81%) use a numerical scale. The use of standing orders at triage is variable.
  
  
  CONCLUSIONS
  Despite the important decisions made based on triage assessment in a pediatric ED, there is wide variability in the parameters assessed and the methodology used. Additional research should focus on the validity and reliability of each assessment to determine the best practices.
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences College of Medicine, and Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Tonya
authors.initials: T
authors.lastname: Thompson
authors.forename: Kendall
authors.initials: K
authors.lastname: Stanford
authors.forename: Rhonda
authors.initials: R
authors.lastname: Dick
authors.forename: James
authors.initials: J
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D002648:Child; D002654:Child Care / Q000379:methods*; D002675:Child, Preschool; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care; D014218:Triage / Q000458:organization & administration*; D014481:United States; D055815:Young Adult