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A 4-year review of severe pediatric trauma in eastern Ontario: a descriptive analysis.

https://arctichealth.org/en/permalink/ahliterature191929
Source
J Trauma. 2002 Jan;52(1):8-12
Publication Type
Article
Date
Jan-2002
Author
Martin H Osmond
Maureen Brennan-Barnes
Allyson L Shephard
Author Affiliation
Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada. osmond@cheo.on.ca
Source
J Trauma. 2002 Jan;52(1):8-12
Date
Jan-2002
Language
English
Publication Type
Article
Keywords
Accident prevention
Accidental Falls - prevention & control - statistics & numerical data
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Age Distribution
Athletic Injuries - epidemiology - etiology - prevention & control
Child
Child Abuse - prevention & control - statistics & numerical data
Child, Preschool
Craniocerebral Trauma - epidemiology - etiology - prevention & control
Female
Hospitals, Pediatric - statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Ontario - epidemiology
Retrospective Studies
Sex Distribution
Time Factors
Trauma Centers - statistics & numerical data
Trauma Severity Indices
Wounds and Injuries - epidemiology - etiology - prevention & control
Abstract
The objective of this study was to describe a population of children admitted to a tertiary care pediatric hospital with severe trauma to identify key areas for injury prevention research, and programming.
Retrospective chart review conducted on all children 0-17 years admitted to the Children's Hospital of Eastern Ontario (CHEO) between April 1, 1996, and March 31, 2000, following acute trauma. Each record was reviewed and assigned an ISS using the AIS 1990 revision. All cases with an ISS > 11 were included in the study.
There were 2610 trauma cases admitted to CHEO over the study period. Of these, 237 (9.1%) had severe trauma (ISS > 11). Sixty-two percent were male. Twenty-nine percent were between the ages of 10 and 14 years, 27% between 5 and 9 years, 16% between 15 and 17 years, 15% between 1 and 4 years, and 13% less than 1 year old. The most common mechanisms of injury were due to motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%). Of those resulting from motor vehicle traffic, 53 (57%) were occupants, 22 (24%) were pedestrians, and 18 (19%) were cyclists. When combining traffic and nontraffic mechanisms, 26 (11% of all severe trauma cases) occurred as a result of cycling incidents. The most severe injury in 65% of patients was to the head and neck body region.
Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.
PubMed ID
11791045 View in PubMed
Less detail

The availability and use of out-of-hospital physiologic information to identify high-risk injured children in a multisite, population-based cohort.

https://arctichealth.org/en/permalink/ahliterature148721
Source
Prehosp Emerg Care. 2009 Oct-Dec;13(4):420-31
Publication Type
Article
Author
Craig D Newgard
Kyle Rudser
Dianne L Atkins
Robert Berg
Martin H Osmond
Eileen M Bulger
Daniel P Davis
Martin A Schreiber
Craig Warden
Thomas D Rea
Scott Emerson
Author Affiliation
Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon 97239-3098, USA. newgardc@ohsu.edu
Source
Prehosp Emerg Care. 2009 Oct-Dec;13(4):420-31
Language
English
Publication Type
Article
Keywords
Adolescent
Canada
Child
Child, Preschool
Emergency medical services
Humans
Infant
Infant, Newborn
Prospective Studies
Risk assessment
Trauma Centers
Triage - organization & administration
United States
Wounds and Injuries - physiopathology
Abstract
The validity of using adult physiologic criteria to triage injured children in the out-of-hospital setting remains unproven. Among children meeting adult field physiologic criteria, we assessed the availability of physiologic information, the incidence of death or prolonged hospitalization, and whether age-specific criteria would improve the specificity of the physiologic triage step.
We analyzed a prospective, out-of-hospital cohort of injured children aged 29 breaths/min, Glasgow Coma Scale (GCS) score 2 days. The decision tree was derived and validated using binary recursive partitioning.
Nine hundred fifty-five children were included in the analysis, of whom 62 (6.5%) died and 117 (12.3%) were hospitalized > 2 days. Missing values were common, ranging from 6% (respiratory rate) to 53% (pulse oximetry), and were associated with younger age and high-risk outcome. The final decision rule included four variables (assisted ventilation, GCS score 96 mmHg), which demonstrated improved specificity (71.7% [95% confidence interval (CI) 66.7-76.6%]) at the expense of missing high-risk children (sensitivity 76.5% [95% CI 66.4-86.6%]).
The incidence of high-risk injured children meeting adult physiologic criteria is relatively low and the findings from this sample do not support using age-specific values to better identify such children. However, the amount and pattern of missing data may compromise the value and practical use of field physiologic information in pediatric triage.
Notes
Cites: J Pediatr Surg. 2000 Jan;35(1):82-710646780
Cites: Acad Emerg Med. 2010 Feb;17(2):142-5020370743
Cites: J Trauma. 2002 Sep;53(3):503-712352488
Cites: J Trauma. 1985 Jun;25(6):482-94009748
Cites: Ann Emerg Med. 1989 Oct;18(10):1053-82802280
Cites: JAMA. 1990 Jan 5;263(1):69-722293691
Cites: Ann Emerg Med. 1990 Feb;19(2):173-82301796
Cites: J Trauma. 1991 Apr;31(4):452-7; discussion 457-82020031
Cites: J Pediatr Surg. 1993 Mar;28(3):299-303; discussion 304-58468636
Cites: Arch Surg. 1995 Feb;130(2):171-67848088
Cites: Am J Emerg Med. 1996 Mar;14(2):124-98924131
Cites: J Pediatr Surg. 1996 Jan;31(1):72-6; discussion 76-78632290
Cites: Acad Emerg Med. 1996 Nov;3(11):992-10008922003
Cites: Pediatr Emerg Care. 1996 Dec;12(6):394-98989783
Cites: J Trauma. 1997 Mar;42(3):514-99095120
Cites: Pediatr Neurosurg. 1996 Dec;25(6):309-149348151
Cites: Ann Emerg Med. 1999 Apr;33(4):437-4710092723
Cites: J Am Coll Surg. 2005 Apr;200(4):584-9215804473
Cites: J Pediatr Surg. 2005 Jun;40(6):926-8; discussion 92815991172
Cites: Acad Emerg Med. 2005 Aug;12(8):679-8716079420
Cites: J Trauma. 2005 Jul;59(1):84-90; discussion 90-116096544
Cites: Acad Emerg Med. 2005 Sep;12(9):814-916141014
Cites: Crit Care Med. 2005 Nov;33(11):2645-5016276192
Cites: J Trauma. 2006 Apr;60(4):792-80116612299
Cites: Pediatr Emerg Care. 2007 Jul;23(7):450-617666925
Cites: Prehosp Emerg Care. 2007 Oct-Dec;11(4):369-8217907019
Cites: J Pediatr Surg. 2008 Jan;43(1):212-2118206485
Cites: Resuscitation. 2008 Aug;78(2):170-818482792
Cites: J Trauma. 2010 Feb;68(2):452-6220154558
Cites: JAMA. 2000 Feb 9;283(6):783-9010683058
PubMed ID
19731152 View in PubMed
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Barriers to metered-dose inhaler/spacer use in Canadian pediatric emergency departments: a national survey.

https://arctichealth.org/en/permalink/ahliterature161885
Source
Acad Emerg Med. 2007 Nov;14(11):1106-13
Publication Type
Article
Date
Nov-2007
Author
Martin H Osmond
Madlen Gazarian
Richard L Henry
Tammy J Clifford
Jennifer Tetzlaff
Author Affiliation
Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada. osmond@cheo.on.ca
Source
Acad Emerg Med. 2007 Nov;14(11):1106-13
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Asthma - therapy
Canada
Child
Cross-Sectional Studies
Emergency Service, Hospital - statistics & numerical data
Health Care Surveys
Hospitals, Teaching
Humans
Metered Dose Inhalers - utilization
Abstract
Metered-dose inhalers and spacers (MDI+S) are at least as effective as nebulizers for treating children with mild to moderate asthma exacerbations. Despite advantages in terms of efficacy, side effects, and ease of use, MDI+S are not used in many North American pediatric emergency departments (PEDs).
To survey emergency physicians, emergency nurses, and respirologists in Canadian pediatric teaching hospitals regarding their practices, beliefs, and barriers to change with respect to bronchodilator delivery.
This was a cross-sectional, mailed survey of all emergency physicians, all respirologists, and a random sample of emergency nurses at ten Canadian PEDs.
A total of 291 of 349 health care professionals (83%) responded. Twenty-one percent of emergency physicians use MDI+S in the PED (largely concentrated at two "user sites"). A majority at nonuser sites, and virtually all professionals at user sites, responded that MDI+S are at least as effective as nebulizers, switching to MDI+S is justified by existing research, patient outcomes would be equal or better, and they have the required knowledge and skills to use MDI+S in the emergency department. The largest perceived barriers to MDI+S implementation include concerns regarding safety and costs, related to feasibility of providing and sterilizing spacers, and parental expectations for nebulizers. Other barriers included staff beliefs regarding the effectiveness of MDI+S, changes in nursing workload, and lack of a physician champion for change.
MDI+S are infrequently used to treat patients with acute asthma in Canadian PEDs, despite the fact that most emergency staff believe they are effective. Important barriers to using MDI+S have been identified in this study and should be used to guide future implementation strategies.
PubMed ID
17699806 View in PubMed
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The Canadian Triage and Acuity Scale for children: a prospective multicenter evaluation.

https://arctichealth.org/en/permalink/ahliterature127335
Source
Ann Emerg Med. 2012 Jul;60(1):71-7.e3
Publication Type
Article
Date
Jul-2012
Author
Jocelyn Gravel
Serge Gouin
Ran D Goldman
Martin H Osmond
Eleanor Fitzpatrick
Kathy Boutis
Chantal Guimont
Gary Joubert
Kelly Millar
Sarah Curtis
Douglas Sinclair
Devendra Amre
Author Affiliation
Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada. graveljocelyn@hotmail.com
Source
Ann Emerg Med. 2012 Jul;60(1):71-7.e3
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Canada
Child
Child, Preschool
Emergency Service, Hospital
Female
Health Resources - utilization
Hospitalization - statistics & numerical data
Hospitals, Pediatric
Hospitals, University
Humans
Infant
Length of Stay - statistics & numerical data
Male
Multivariate Analysis
Nurses
Observer Variation
Prospective Studies
Regression Analysis
Reproducibility of Results
Single-Blind Method
Trauma Severity Indices
Triage - methods
Abstract
The aims of the study are to measure both the interrater agreement of nurses using the Canadian Triage and Acuity Scale in children and the validity of the scale as measured by the correlation between triage level and proxy markers of severity.
This was a prospective multicenter study of the reliability and construct validity of the Canadian Triage and Acuity Scale in 9 tertiary care pediatric emergency departments (EDs) across Canada during 2009 to 2010. Participants were a sample of children initially triaged as Canadian Triage and Acuity Scale level 2 (emergency) to level 5 (nonurgent). Participants were recruited immediately after their initial triage to undergo a second triage assessment by the research nurse. Both triages were performed blinded to the other. The primary outcome measures were the interrater agreement between the 2 nurses and the association between triage level and hospitalization. Secondary outcome measures were the association between triage level and health resource use and length of stay in the ED.
A total of 1,564 patients were approached and 1,464 consented. The overall interrater agreement was good, as demonstrated by a quadratic weighted ? score of 0.74 (95% confidence interval 0.71 to 0.76). Hospitalization proportions were 30%, 8.3%, 2.3%, and 2.2% for patients triaged at levels 2, 3, 4, and 5, respectively. There was also a strong association between triage levels and use of health care resources and length of stay.
The Canadian Triage and Acuity Scale demonstrates a good interrater agreement between nurses across multiple pediatric EDs and is a valid triage tool, as demonstrated by its good association with markers of severity.
PubMed ID
22305329 View in PubMed
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Consensus-based recommendations for standardizing terminology and reporting adverse events for emergency department procedural sedation and analgesia in children.

https://arctichealth.org/en/permalink/ahliterature154089
Source
Ann Emerg Med. 2009 Apr;53(4):426-435.e4
Publication Type
Conference/Meeting Material
Article
Date
Apr-2009
Author
Maala Bhatt
Robert M Kennedy
Martin H Osmond
Baruch Krauss
John D McAllister
J Mark Ansermino
Lisa M Evered
Mark G Roback
Author Affiliation
Division of Emergency Medicine, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. maala.bhatt@muhc.mcgill.ca
Source
Ann Emerg Med. 2009 Apr;53(4):426-435.e4
Date
Apr-2009
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Adverse Drug Reaction Reporting Systems
Analgesia - adverse effects - standards
Canada
Child
Conscious Sedation - adverse effects - standards
Documentation - standards
Emergency Service, Hospital - standards
Emergency Treatment
Humans
Pediatrics - standards
Terminology as Topic
Abstract
Children commonly require sedation and analgesia for procedures in the emergency department. Establishing accurate adverse event and complications rates from the available literature has been difficult because of the difficulty in aggregating results from previous studies that have used varied terminology to describe the same adverse events and outcomes. Further, serious adverse events occur infrequently, necessitating the study of large numbers of children to assess safety. These limitations prevent the establishment of a sufficiently large database on which evidence-based practice guidelines may be based. We assembled a panel of pediatric sedation researchers and experts to develop consensus-based recommendations for standardizing procedural sedation and analgesia terminology and reporting of adverse events. Our goal was to create a uniform reporting mechanism for future studies to facilitate the aggregation and comparison of results.
Notes
Comment In: Ann Emerg Med. 2009 Apr;53(4):436-819097672
PubMed ID
19026467 View in PubMed
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Etiology of pediatric out-of-hospital cardiac arrest by coroner's diagnosis.

https://arctichealth.org/en/permalink/ahliterature170887
Source
Resuscitation. 2006 Mar;68(3):335-42
Publication Type
Article
Date
Mar-2006
Author
Marcus E H Ong
Ian Stiell
Martin H Osmond
Lisa Nesbitt
Rick Gerein
Starla Campbell
Barry McLellan
Author Affiliation
Department of Emergency Medicine, University of Ottawa, Canada. gaeoeh@sgh.com.sg
Source
Resuscitation. 2006 Mar;68(3):335-42
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Accidents - statistics & numerical data
Adolescent
Age Distribution
Cardiopulmonary Resuscitation - statistics & numerical data
Cause of Death
Child
Child, Preschool
Coroners and Medical Examiners
Drowning - mortality
Female
Fires - statistics & numerical data
Heart Arrest - diagnosis - etiology - mortality
Homicide - statistics & numerical data
Humans
Incidence
Infant
Injury Severity Score
Male
Ontario - epidemiology
Prospective Studies
Sudden Infant Death - epidemiology
Suicide - statistics & numerical data
Abstract
To determine etiology of pediatric OHCA in a population-based sample from autopsy and coroner's diagnosis.
As part of the Ontario Pre-hospital Advanced Life Support (OPALS) study, we conducted a prospective cohort study including children below age 19 years with OHCA in an 11-year period. Deaths were matched with provincial coroner's office records and autopsies and investigation notes were reviewed.
From 1992 to 2002, there were 474 cardiac arrests in children below 19 years of age giving an annual incidence of 59.7 per million children. Mean age was 5.8 (S.D. 6.3), 43.0% were
PubMed ID
16455177 View in PubMed
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Factors associated with the successful recognition of abnormal breathing and cardiac arrest by ambulance communications officers: a qualitative iterative survey.

https://arctichealth.org/en/permalink/ahliterature123283
Source
Prehosp Emerg Care. 2012 Oct-Dec;16(4):443-50
Publication Type
Article
Author
Jan L Jensen
Christian Vaillancourt
Jessica Tweedle
Ann Kasaboski
Manya Charette
Jeremy Grimshaw
Jamie C Brehaut
Martin H Osmond
George A Wells
Ian G Stiell
Author Affiliation
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Source
Prehosp Emerg Care. 2012 Oct-Dec;16(4):443-50
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Canada
Cardiopulmonary Resuscitation
Emergency Medical Service Communication Systems
Female
Heart Arrest - diagnosis
Humans
Interviews as Topic
Male
Professional Competence
Respiration Disorders - diagnosis
Abstract
We sought to identify barriers and facilitators to ambulance communications officers' (ACOs') recognition of abnormal breathing and administration of cardiopulmonary resuscitation (CPR) instructions.
We conducted semistructured qualitative interviews based on the constructs of the Theory of Planned Behavior to elicit salient attitudes, social influences, and behavioral controls potentially influencing ACOs' intent to recognize abnormal breathing as a symptom of cardiac arrest and administer CPR instructions over the phone. We conducted interviews until achieving data saturation. We recorded interviews and transcribed them verbatim. Two independent reviewers performed inductive analyses to identify emerging themes.
We interviewed 24 ACOs from four Canadian provinces (67% female, median 9.5 years of experience, 33% with paramedic training). We identified eight behavioral, 14 subjective normative, and 22 control beliefs. Important attitudes were as follows: 1) CPR instructions may help the patient and are likely to be beneficial for the caller; 2) abnormal breathing is an early sign of cardiac arrest; and 3) dispatch-assisted CPR instructions can improve survival. The leading social influence was management/quality assurance staff. Behavioral control was the construct most associated with ACOs' ability to recognize abnormal breathing, including 1) adherence to mandatory scripted protocol, 2) poor caller description of breathing pattern, and 3) ACO training on abnormal breathing.
This qualitative study found that control beliefs are most influential on ACOs' intention to recognize abnormal breathing and provide CPR instructions over the phone. Training and policy changes should target these beliefs to increase the frequency of ACO-administered CPR instructions to callers reporting a patient in cardiac arrest.
PubMed ID
22712635 View in PubMed
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Management and outcomes of pediatric patients transported by emergency medical services in a Canadian prehospital system.

https://arctichealth.org/en/permalink/ahliterature166031
Source
CJEM. 2006 Jan;8(1):6-12
Publication Type
Article
Date
Jan-2006
Author
Julie Richard
Martin H Osmond
Lisa Nesbitt
Ian G Stiell
Author Affiliation
Faculty of Medicine, University of Ottawa, Ottawa, ON.
Source
CJEM. 2006 Jan;8(1):6-12
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Advanced Cardiac Life Support - statistics & numerical data
Blood Glucose - analysis
Blood pressure
Canada - epidemiology
Cervical Vertebrae - injuries
Child
Child, Preschool
Female
Heart rate
Humans
Immobilization - instrumentation
Intensive Care Units
Intubation, Intratracheal - statistics & numerical data
Male
Monitoring, Physiologic
Oxygen - administration & dosage
Patient Admission - statistics & numerical data
Prospective Studies
Respiration, Artificial - instrumentation - statistics & numerical data
Respiratory Insufficiency - epidemiology
Seizures - epidemiology
Suction - statistics & numerical data
Transportation of Patients - statistics & numerical data
Wounds and Injuries - epidemiology
Abstract
There is uncertainty around the types of interventions that are provided by emergency medical services (EMS) to children during prehospital transport. We describe the patient characteristics, events, interventions provided and outcomes of a cohort of children transported by EMS.
This prospective cohort study was conducted in a city of 750 000 people with a 2-tiered EMS system. All children
PubMed ID
17175623 View in PubMed
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Out-of-hospital pediatric cardiac arrest: an epidemiologic review and assessment of current knowledge.

https://arctichealth.org/en/permalink/ahliterature171830
Source
Ann Emerg Med. 2005 Dec;46(6):512-22
Publication Type
Article
Date
Dec-2005
Author
Aaron J Donoghue
Vinay Nadkarni
Robert A Berg
Martin H Osmond
George Wells
Lisa Nesbitt
Ian G Stiell
Author Affiliation
Division of Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. donoghue@email.chop.edu
Source
Ann Emerg Med. 2005 Dec;46(6):512-22
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Canada - epidemiology
Cardiopulmonary Resuscitation - methods - statistics & numerical data
Causality
Child
Child, Preschool
Emergency Medical Services - methods - statistics & numerical data
Heart Arrest - epidemiology - therapy
Humans
Incidence
Infant
Infant, Newborn
Near Drowning - epidemiology
Outcome and Process Assessment (Health Care)
Patient Admission - statistics & numerical data
Pediatrics - methods - statistics & numerical data
Sudden Infant Death - epidemiology
Survival Analysis
United States - epidemiology
Wounds and Injuries - epidemiology
Abstract
We systematically summarize pediatric out-of-hospital cardiac arrest epidemiology and assess knowledge of effects of specific out-of-hospital interventions.
We conducted a comprehensive review of published articles from 1966 to 2004, available through MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EmBase, and the Cochrane Registry, describing outcomes of children younger than 18 years with an out-of-hospital cardiac arrest. Patient characteristics, process of care, and outcomes were compared using pediatric Utstein outcome report guidelines. Effects of out-of-hospital care processes on survival outcomes were summarized.
Forty-one studies met inclusion criteria; 8 complied with Utstein reporting guidelines. Included in the review were 5,363 patients: 12.1% survived to hospital discharge, and 4% survived neurologically intact. Trauma patients (n=2,299) had greater overall survival (21.9%, 6.8% intact); a separate examination of studies with more rigorous cardiac arrest definition showed poorer survival (1.1% overall, 0.3% neurologically intact). Submersion injury-associated arrests (n=442) had greater overall survival (22.7%, 6% intact). Pooled data analysis of bystander cardiopulmonary resuscitation and witnessed arrest status showed increased likelihood of survival (relative risk 1.99, 95% confidence interval 1.54 to 2.57) for witnessed arrests. The effect of bystander cardiopulmonary resuscitation is difficult to determine because of study heterogeneity.
Outcomes from out-of-hospital pediatric cardiac arrest are generally poor. Variability may exist in survival by patient subgroups, but differences are hard to accurately characterize. Conformity with Utstein guidelines for reporting and research design is incomplete. Witnessed arrest status remains associated with improved survival. The need for prospective controlled trials remains a high priority.
Notes
Comment In: Ann Emerg Med. 2006 Aug;48(2):21916857476
Comment In: Ann Emerg Med. 2005 Dec;46(6):523-416308067
PubMed ID
16308066 View in PubMed
Less detail

Performance of the Canadian Triage and Acuity Scale for children: a multicenter database study.

https://arctichealth.org/en/permalink/ahliterature122168
Source
Ann Emerg Med. 2013 Jan;61(1):27-32.e3
Publication Type
Article
Date
Jan-2013
Author
Jocelyn Gravel
Eleanor Fitzpatrick
Serge Gouin
Kelly Millar
Sarah Curtis
Gary Joubert
Kathy Boutis
Chantal Guimont
Ran D Goldman
Alexander S Dubrovsky
Robert Porter
Darcy Beer
Quynh Doan
Martin H Osmond
Author Affiliation
Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada. graveljocelyn@hotmail.com
Source
Ann Emerg Med. 2013 Jan;61(1):27-32.e3
Date
Jan-2013
Language
English
Geographic Location
Canada
Publication Type
Article
Keywords
Adolescent
Canada
Child
Child, Preschool
Databases, Factual
Emergency Service, Hospital - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Hospitals, Pediatric
Hospitals, University
Humans
Infant
Intensive Care Units - statistics & numerical data
Male
Outcome Assessment (Health Care)
Patient Acuity
Retrospective Studies
Tertiary Care Centers
Triage - methods - statistics & numerical data
Abstract
We evaluate the association between triage levels assigned using the Canadian Triage and Acuity Scale and surrogate markers of validity for real-life children triaged in multiple emergency departments (EDs).
This was a retrospective cohort study evaluating the triage assessment and outcomes of all children presenting to 12 pediatric EDs, all of which are members of the Pediatric Emergency Research Canada group, during a 1-year period (2010 to 2011). Anonymous data were retrieved from the ED computerized databases. The primary outcome measure was the proportion of children hospitalized for each triage level. Other outcomes were ICU admission, proportion of patients who left without being seen by a physician, and length of stay in the ED. Evaluation of all children visiting these EDs during 1 year was expected to provide more than 1,000 patients in each triage category.
A total of 550,940 children were included. Pooled data demonstrated hospitalization proportions of 61%, 30%, 10%, 2%, and 0.9% for patients in Canadian Triage and Acuity Scale levels 1, 2, 3, 4, and 5, respectively. There was a strong association between triage level and admission to the ICU, probability of leaving without being seen by a physician, and length of stay.
The strong association between triage level and multiple markers of severity in 12 Canadian pediatric EDs suggests validity of the Canadian Triage and Acuity Scale for children.
Notes
Comment In: Ann Emerg Med. 2013 Mar;61(3):372-323433024
Comment In: Ann Emerg Med. 2013 Jan;61(1):33-422883682
PubMed ID
22841173 View in PubMed
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14 records – page 1 of 2.