The accuracy of existing prehospital triage tools for injured children in England: an analysis using emergency department data.
OBJECTIVE
To investigate the performance characteristics in children with moderate and minor injuries of prehospital paediatric triage tools currently in use in England for identifying seriously injured children.


METHODS
Eight prehospital paediatric triage tools were identified from literature review and a survey of the lead trauma clinicians across the 10 English strategic health authorities. Retrospective clinical data from 2934 patient records collected by four emergency departments were used to analyse each tool. A target sensitivity of >95% and specificity of 50-75% was set based on the literature.


RESULTS
Three tools (East Midlands, North West and Northern) demonstrated acceptable sensitivity (all 100%). The other five tools fell below the target sensitivity of >95%. All eight tools had acceptable specificity (with results between 79% and 99%).


CONCLUSIONS
Three tools (East Midlands, North West and Northern) demonstrated acceptable over- and under-triage rates in this population of minor and moderately injured children. All tools reached recommended standards for over-triage, but the majority favoured under-triage.
Royal Hampshire Hospital, Winchester, UK.
Antonella
A
Ardolino
Department of Paediatrics, St Thomas' Hospital, London, UK.
C Ronny
CR
Cheung
The Trauma Audit and Research Network, University of Manchester, Hope Hospital, Salford, UK.
Thomas
T
Lawrence
The Trauma Audit and Research Network, University of Manchester, Hope Hospital, Salford, UK.
Omar
O
Bouamra
University of Manchester/Salford Royal Hospital, Salford, UK Health Services Research Group, School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
Fiona
F
Lecky
Birmingham Children's Hospital, Birmingham, UK.
Kathleen
K
Berry
Bristol Royal Hospital for Children, Bristol, UK.
Mark
M
Lyttle
University of Leicester, Leicester, UK.
Damian
D
Roland
St Marys Hospital, Imperial College NHS Healthcare Trust, London, UK.
Nadeeja
N
Koralage
St Marys Hospital, Imperial College NHS Healthcare Trust, London, UK.
Shabara
S
Issa
Leicester Royal Infirmary, Leicester, UK.
Adeel
A
Chaudhary
Leicester Royal Infirmary, Leicester, UK.
Ian
I
Maconochie
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D004739:England / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D016013:Likelihood Functions; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014218:Triage / Q000379:methods*; D014947:Wounds and Injuries / Q000453:epidemiology*
Emergency Department; Major Trauma Management; Paediatric Injury; Pre-Hospital; Trauma