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

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 staff 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 emergency triage in LMICs where there is a dearth of professional  medical personnel.