Evaluation of guidelines for emergency triage assessment and treatment in developing countries

Aim-To evaluate performance of a simplified algorithm and treatment instruc tions for emergency triage assessment and treatment (ETAT) of children pres enting to hospital in developing countries. Methods-All infants aged 7 days to 5 years presenting to an accident and em ergency department were simultaneously triaged and assessed by a nurse and a senior paediatrician. Nurse ETAT assessment was compared to standard emer gency advanced paediatric life support (APLS) assessment by the paediatrici an. Sensitivity, specificity, and predictive values were calculated and app ropriateness of nurse treatments was evaluated. Results-The ETAT algorithm as used by nurses identified 731/3837 patients ( 19.05%); 98 patients (2.6%) were classified as needing emergency treatment and 633 (16.5%) as needing priority assessment. Sensitivity was 96.7% with respect to APLS assessment, 91.7% with respect to all patients given priori ty by the paediatrician, and 85.7% with respect to patients ultimately admi tted. Specificity was 90.6%, 91.0%, and 85.2%, respectively. Nurse administ ered treatment was appropriate in 94/102 (92.2%) emergency conditions. Conclusions-The ETAT algorithm and treatment instructions, when carried out by nurses after a short specific training period, performed well as a scre ening tool to identify priority cases and as a treatment guide for emergenc y conditions.