Efficacy of implementation of a 5 scale pediatric triage and acuity scale in pediatric emergency, Saudi Arabia.

OBJECTIVES To evaluate the effectiveness of implementation of the pediatric Canadian Triage and Acuity Scale (Ped-CTAS) for children visiting the pediatric emergency department (ED). METHODS This cross-sectional study evaluated all children presented to the ED during a 9-day period in March 2010. The Ped-CTAS triage system was used. Triage performance was analyzed on the basis of quality indicators, rate of admissions, rate of referral, observation duration, and relationship between investigations requested and CTAS level. RESULTS During the study period, 3,337 patients were triaged. Overall, 4 patients (0.1%) were in triage level 1, 356 (12%) were level 2, 655 (22%) were level 3, 1810 (60%) were level 4, and 189 (6%) were level 5. The left without being seen rate was 6.25%. A triage duration of 5 minutes or less was carried out for 97% of cases. Within the CTAS time objectives, the waiting time to nurse and physician was 100% for cases triaged to level 1. The proportion of cases who needed observation was 100% for level 1, 85% for level 2, 53% for level 3, 33% for level 4, and 26% for level 5. The proportion of patients admitted to the hospital was 100% for level 1. The lower the level (more acute and emergent the condition) the more use of the laboratory and radiological investigations. CONCLUSION The pediatric CTAS triage system is a good tool for categorizing pediatric patients attending the ED. Stratified by triage level, triage indicators can be used as indicators of ED performance.