title: An adapted triage tool (ETAT) at Red Cross War Memorial Children's Hospital Medical Emergency Unit, Cape Town: an evaluation.
abstract: OBJECTIVE
  To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children's hospital.
  
  
  METHODS
  A two-armed descriptive study.
  
  
  METHODS
  Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
  
  
  METHODS
  Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated.
  
  
  RESULTS
  1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1).
  
  
  CONCLUSIONS
  The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings.
authors.affiliation: Red Cross War Memorial Children's Hospital, Cape Town, South Africa. heloise.buys@uct.ac.za.
authors.forename: H
authors.initials: H
authors.lastname: Buys
authors.forename: R
authors.initials: R
authors.lastname: Muloiwa
authors.forename: C
authors.initials: C
authors.lastname: Westwood
authors.forename: D
authors.initials: D
authors.lastname: Richardson
authors.forename: B
authors.initials: B
authors.lastname: Cheema
authors.forename: A
authors.initials: A
authors.lastname: Westwood
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004630:Emergencies / Q000145:classification / Q000453:epidemiology / Q000451:nursing; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000379:methods / Q000451:nursing / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015399:Nursing Research / Q000379:methods; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D062072:Patient Acuity; D013019:South Africa / Q000453:epidemiology; D014218:Triage / Q000379:methods / Q000706:statistics & numerical data