Respiratory diseases in pediatric triage: a comparison between a general emergency department and a pediatric emergency department.
OBJECTIVE
In this study, the authors have compared data concerning the pediatric triage that is carried out in 2 large emergency departments (EDs) in Rome, one located in a university pediatric clinic with qualified staff and the other one in a general hospital with a high flow of users and pediatric admissions.


METHODS
A total of 324 children were selected (162 per hospital) with ages between 0 and 3 years who went to the ED in the period from October to December 2009 for respiratory pathologic findings at the lower respiratory tracts' expense. We took and compared the following data: assignation of the color code, congruity of the color code, and realization of the reevaluation.


CONCLUSIONS
This study reveals several differences between the 2 structures considered with a clear tendency of nurses of the general ED to underestimate color codes, giving undertriage rates in a significant number of cases. Another significantly important difference was found on the detection of children's vital parameters. One last important parameter that emerged from this study was the lack of attention to the reevaluation of the patient after admission in ED.


RESULTS
In the light of what we pointed out, it is necessary to implement the educational and informative quality of the triage operators and educators, planning periodical triage training courses to reduce errors. Particular emphasis must be placed on providing pediatric continuing education for nurses practicing in general ED.
From the *Emergency and Intensive Care Unit, Department of Pediatrics, Sapienza University of Rome †Respiratory Diseases Unit, Department of Pediatrics, Sapienza University of Rome; and ‡Sandro Pertini Hospital, Rome, Italy.
Valeria
V
Tromba
Matteo
M
Moretti
Valerio
V
Massaccesi
Ilaria
I
Peparini
Chiara
C
Pistoletti
Viviana
V
Salerno
D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006769:Hospitals, General / Q000458:organization & administration*; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration; D010372:Pediatrics; D012384:Rome; D014218:Triage / Q000458:organization & administration*