Horeczko et al.66 Horeczko T, Enriquez B, McGrath NE, Gausche-Hill M, Lewis RJ. The Pediatric Assessment Triangle: accuracy of its application by nurses in the triage of children. J Emerg Nurs. 2013;39:182-9.
2013 |
PAT ED triage |
To determine quantitatively the PAT's accuracy, reliability, and validity as applied by nurses at triage. |
528 |
Prospective, observational |
PAT readily and reliably identifies highly acute pediatric patients and their category of pathophysiology. |
Mierek et al.1010 Mierek C, Nacca N, Scott JM, Wojcik SM, D'Agostino J, Dougher K, et al. View from the door: making pediatric transport decisions based on first impressions. JEMS. 2010;35:68-9, 71, 73, 75, 77, 79, 81.
2010 |
PAT Prehospital setting |
To determine if experienced providers can use the information gathered from the "view from the door" to make transport decisions on pediatric patients, and if that information agrees with the PAT. |
18 video cases of pediatric patients |
Ethnographic analysis strategies to develop themes. Recorded decision-making processes compared to standard triage criteria. |
The providers extracted information from a remote location about pediatric patients that could be organized into a tool similar to the PAT and that directly contributed to transport decisions in a time-efficient manner. |
Gausche-Hill et al.1212 Gausche-Hill M, Eckstein M, Horeczko T, McGrath N, Kurobe A, Ullum L, et al. Paramedics accurately apply the pediatric assessment triangle to drive management. Prehosp Emerg Care. 2014;18:520-30.
2014 |
PAT Prehospital setting |
To provide an evaluation of the PAT as an assessment tool for use by paramedic providers in the prehospital care of pediatric patients. |
1168 |
Prospective, observational |
Substantial agreement between the PAT Paramedic Impression and the investigators' retrospective chart review. The PAT showed a 77.4% sensitivity and 90% specificity for instability. The PAT is a rapid assessment tool that can be readily and reliably used by paramedics in the prehospital setting. |
Fernandez et al.2222 Fernandez A, Ares MI, García S, Martínez-Indart L, Mintegi S, Benito J. The validity of the Pediatric Assessment Triangle as the first step in the triage process in a pediatric emergency department. Pediatr Emerg Care. 2017;33:234-8.
2017 |
PAT ED triage |
To assess the association between PAT findings during triage and markers of severity in a pediatric ED. |
302,103 |
Retrospective cohort study |
PAT findings were an independent risk factor for admission (OR, 2.21; 95% CI, 2.13-2.29); for intensive care unit admission (OR, 4.44; 95% CI, 3.77-5.24), and a longer stay in the PED (OR, 1.78; 95% CI, 1.72-1.84). The PAT appears to be a valid tool for identifying the most severe patients as a first step in the triage process. |
Paniagua et al.2323 Paniagua N, Elosegi A, Duo I, Fernandez A, Mojica E, Martinez-Indart L, et al. Initial asthma severity assessment tools as predictors of hospitalization. J Emerg Med. 2017: pii:S0736-4679(17)30233-0.
2017 |
PAT ED triage |
To assess the performance of the PAT, triage level, pulmonary score, and initial O2 saturation in predicting hospitalization in pediatric acute asthma exacerbations. |
14,953 |
Retrospective cohort study |
Abnormal PAT was an independent risk factor for hospitalization (OR: 1.6, 95% CI: 1.4-1.8) and for a longer LOS (OR: 1.5, 95% CI: 1.3-1.7). Among the components of PAT, abnormal circulation to the skin was the best predictor of hospitalization (OR: 1.8, 95% CI: 1.2-2.9). |
Bradman et al.2626 Bradman K, Maconochie I. Can paediatric early warning score be used as a triage tool in paediatric accident and emergency?. EJEM. 2008;15:359-60.
2008 |
PEWS ED triage |
To assess if the PEWS could detect children at triage who need admission. |
424 |
Prospective, observational |
PEWS scoring at ED triage had low sensitivity and therefore had limited value in predicting the need for admission. |
Seiger et al.2727 Seiger N, Maconochie I, Oostenbrink R. Validity of different pediatric early warning scores in the emergency department. Pediatrics. 2013;132:e841-50.
2013 |
PEWS ED triage |
To compare the performance of different PEWS to predict ICU admission or hospitalization in children visiting the pediatric ED. |
17,943 |
Prospective cohort study |
The discriminative ability of the PEWS (area under the ROC curve) were moderate to good for ICU admission (range: 0.602 0.82) and poor to moderate for admission to the hospital (range: 0.562-0.68). At present, there is no evidence that PEWS are better than conventional triage systems. |
Gold et al.2828 Gold DL, Mihalov LK, Cohen DM. Evaluating the Pediatric Early Warning Score (PEWS) system for admitted patients in the pediatric emergency department. Acad Emerg Med. 2014;21:1249-56.
2014 |
PEWS ED |
To explore if the PEWS assigned in the ED (P0 at initial assessment; P1 at admission) predicts the need for ICU admission from the ED or clinical deterioration. |
12,306 |
Prospective, observational study |
In the ED, alone the tool lacks sufficient test characteristics to determine disposition or predict deterioration on the floor. |
Roland et al.2929 Roland D, Lewis G, Fielding P, Hakim C, Watts A, Davies F. The paediatric observation priority score: a system to aid detection of serious illness and assist in safe discharge. Open J Emerg Med. 2016;4:38-44.
2016 |
POPS ED triage |
To validate POPS as a triage tool. |
936 |
Prospective, observational study |
POPS has demonstrated a functional ability to aid health care professionals' decision making. |
Rowland et al.3030 Rowland A, Cotterill S, Lees H, Kelly J. The Paediatric Observation Priority Score (POPS): a more accurate predictor of admission risk from the emergency fepartment than the Manchester Children's Early Warning System (ManChEWS). Arch Dis Child. 2014;99:A8.
2014 |
POPS ED |
To investigate the ability of PEWS and POPS to predict admission to hospital. |
2068 |
Prospective cohort study |
The PEWS ROC is 0.67 (95% CI 0.65-0.70), SE 0.02, and the POPS ROC is 0.72 (95% CI 0.69-0.75). POPS is a more accurate predictor of admission risk from the ED than PEWS, and is more suitable to use in an ED setting |