Unique triage methods in the paediatric emergency roomof a low resource setting

Abstract

Abstract: Introduction: Despite its importance in emergency medicine, the practice of triage in low- and middle-income countries remains rudimentary, due to dearth of human and material resources, among other reasons.

Subjects and methods: In the Children Emergency Room of a teaching hospital, some nonclinical staff were intermittently deployed to coordinate patient traffic and provide brief first-contact triage on arrival. For this, they were internally trained in triage. The present study was aimed at assessing the value and accuracy of first-contact
triage provided by nonclinical staf in a children emergency department of a tertiary hospital.

Results: Data of 45 patients seen during the period were obtained from the records of the triage officers and included their age, gender, presenting complaints and the findings of the paediatric assessment triangle. There was a statistically significant relationship between the triage ratings of the nonCC –BY 4.0 clinical staff and the qSOFA / L- qSOFA scores obtained by the emergency room doctors, the time spent in CHER and the total duration of admission (R2= 0.36 - 0.44; p = 0.003), (R2= 0.23 - 0.28; p = 0.018) and (R2= 0.33 - 0.40; p = 0.007) respectively.

Conclusion: This study shows that to a high degree, the nonclinical staff correctly categorized the severity of illness in the Paediatric Emergency Department of a tertiary level hospital, thus limiting undue tertiary delay in treatment
and potential harm from such delays. Hence, the study exposes a potential source of human resources for paediatric emergenc triage in LMICs where there is a dearth of professional medical personnel.

Key words: Triage, Children Emergency Room, Irrua Specialist Teaching Hospital, Paediatric Assessment Triangle, Paediatric Emergency Department, National Youth Service Corps