Development and technical basis of simplified guidelines for emergency triage assessment and treatment in developing countries

Simplified guidelines for the emergency care of children have been develope d to improve the triage and rapid initiation of appropriate emergency treat ments for children presenting to hospitals in developing countries. The gui delines are part of the effort to improve referral level paediatric care wi thin the World Health Organisation/Unicef strategy integrated management of childhood illness (IMCI), based on evidence of significant deficiencies in triage and emergency care. Existing emergency guidelines have been modifie d according to resource limitations and significant differences in the epid emiology of severe paediatric illness and preventable death in developing c ountries with raised infant and child mortality rates. In these settings, i t is important to address the emergency management of diarrhoea with severe dehydration, severe malaria, severe malnutrition, and severe bacterial pne umonia, and to focus attention on sick infants younger than 2 months of age . The triage assessment relies on a few clinical signs, which can be readil y taught so that it can be used by health workers with limited clinical bac kground. The assessment has been designed so that it can be carried out qui ckly if negative, making it functional for triaging children in queues.