Triage in the developing world - can it be done?

Aim-To assess guidelines for the emergency triage, assessment, and treatmen t (ETAT) of sick children presenting to hospitals in the developing world. This study pretested the guidelines in Malawi, assessing their performance when used by nurses compared to doctors trained in advanced paediatric life support (APLS). Methods-Triage was performed simultaneously by a nurse and assessing doctor on 2281 children presenting to the under Ss clinic. Each patient was alloc ated one of three priorities, according to the ETAT guidelines. Any variati on between nurse and assessor was recorded on the assessment forms. Results-Nurses identified 92 children requiring emergency treatment and 661 with signs indicating a need for urgent medical assessment. One hundred an d forty two (6.2%) had different priorities allocated by the APLS trained d octor, but these children did not tend to need subsequent admission. Eighty five per cent of admissions were prioritised to an emergency or urgent cat egory. Conclusion-Although there are no gold standards for comparison the ETAT gui delines appear to reliably select out the majority of patients requiring ad mission.