Hostname: page-component-7bb8b95d7b-495rp Total loading time: 0 Render date: 2024-09-23T03:36:34.911Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of the Pediatric Trauma Triage Checklist as a Prehospital Pediatric Trauma Triage Tool for the State of Florida

Published online by Cambridge University Press:  28 June 2012

William P. Johnson
William P. Johnson*
Affiliation:
Quality Management Administrator, Metropolitan Dade County Office of Trauma Services, Miami, Florida
*
Quality Management Administrator, Metropolitan Dade County Office of Trauma Services, 5600 SW 87 Avenue, Miami, FL 33173
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Triage of injured children poses a significant challenge for prehospital-care providers because there is no single trauma triage tool in use that has been developed specifically for children. The pediatric trauma score (PTS) probably is the single most studied and tested trauma triage tool developed solely for the pediatric population, and is an effective predictor of both severity of injury and potential mortality in injured children. However, the pediatric trauma score has been found to be an ineffective prehospital triage tool because it is not “user friendly” for field personnel. As such, the PTS has been modified to generate the more user-friendly ”pediatric trauma triage checklist (PTTC).”

Methods:

This study retrospectively reviewed 106 prehospital run reports to determine whether the patient met one or more of the criteria in the PTTC. By applying the MacKenzie algorithm to outcome data for each case, it was possible to determine whether the patient should have been sent to a trauma center.

Results:

The PTTC demonstrated a sensitivity of 86.2%, a specificity of 41.6%, and an accuracy of 66.0%. The PTTC demonstrate an overtriage rate of 58.3% and an under-triage rate of 13.8%. When compared with a previous study, the PTTC demonstrated a 74 % increase in overtriage. However, the 59% reduction in undertriage is more important.

Conclusions:

Use of the PTTC appears to have merit as a pediatric prehospital trauma triage tool but further study is recommended. The PTTC should be tested in a prospective, multiregional study involving a sample size sufficient to reach statistical significance.

Keywords

pediatric trauma scorePediatric Trauma Triage Checklistprehospital triagetraumatriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 1 , March 1996 , pp. 20 - 26
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Baxt, WG, Berry, CC, Epperson, MD, et al. : The failure of prehospital trauma prediction rules to classify trauma patients accurately. Ann Emerg Med 1989;18:1–8.CrossRefGoogle ScholarPubMed
2. National Association of Emergency Medical Technicians, Prehospital Trauma Life Support Committee: Basic and advanced prehospital trauma life support. 2nd ed. Akron, Ohio: Educational Direction, 1990.Google Scholar
3. Metropolitan Dade County [Florida] Office of Trauma Services: Dade County pediatric trauma registry: 1993 year-end report. Miami: Metropolitan Dade County [Florida] Office of Trauma Services, 1993.Google Scholar
4. Rond, PC, Phillips, S, Kelly, S, et al. : Florida trauma triage study: Final report. Unpublished data, March 1994.Google Scholar
5. Tepas, JJ, Ramenofsky, ML, Mollitt, DL, et al. : The pediatric trauma score as a predictor of injury severity: An objective assessment. J Trauma 1988;28:425–429.CrossRefGoogle ScholarPubMed
6. Kaufmann, CR, Maier, RV, Rivara, FP, et al. : Evaluation of the pediatric trauma score. JAMA 1990;263:69–72.CrossRefGoogle ScholarPubMed
7. Eichelberger, MR, Gotschall, CS, Sacco, WJ, et al. : A comparison of the trauma score, the revised trauma score, and the pediatric trauma score. Ann Emerg Med 1989;18:1053–1058.CrossRefGoogle ScholarPubMed
8. Dierking, BH, Ramenofsky, ML: The pediatric trauma score: An effective method of field triage. Journal of Emergency Medical Services 1988;10:70–73.Google Scholar
9. Johnson, WP: Initial beta-test results: “Medic friendly” pediatric trauma score. Presented at the meeting of the Florida HRS/EMS Office Pediatric Technical Advisory Panel, Hollywood, Fl., 08 March 1994.Google Scholar
10. Nayduch, DA, Rutledge, R, Baker, CC, et al. : Comparison of the ability of adult and pediatric trauma scores to predict pediatric outcome following major trauma. J Trauma 1991;31:452–458.CrossRefGoogle ScholarPubMed
11. Lubitz, DS, Seidel, JS, Chameides, L, et al. : A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group. Ann Emerg Med 1988;17:576–581.CrossRefGoogle ScholarPubMed
12. Luten, RC, Wears, RL, Broselow, J, et al. : Length-based endotracheal tube and emergency equipment in pediatrics. Ann Emerg Med 1992;21:900–904.CrossRefGoogle ScholarPubMed
13. The International Classification of Diseases, 9th Revision Clinical Modification. Geneva, Switzerland: World Health Organization.Google Scholar
14. Abbreviated Injury Scale—1990 Revision. Association for the Advancement of Automotive MedicineGoogle Scholar
15. MacKenzie, EJ, Steinwachs, DM, Ramzy, AI: Evaluating performance of statewide regionalized systems of trauma care. J Trauma 1990;30:681–688.CrossRefGoogle ScholarPubMed