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. 2023 Jan;112(1):154-161.
doi: 10.1111/apa.16567. Epub 2022 Oct 19.

Paediatric major incident triage: A Delphi process to determine clinicians' attitudes and beliefs within the United Kingdom and Ireland

James Vassallo  1   2 , Sarah Blakey  3   4 , Philip Cowburn  5   6   7 , Julia Surridge  8 , Jason E Smith  2   9 , Barney Scholefield  10   11 , Mark D Lyttle  4   5 ; PERUKI (Paediatric Emergency Research in the UK and Ireland)
Collaborators, Affiliations

Paediatric major incident triage: A Delphi process to determine clinicians' attitudes and beliefs within the United Kingdom and Ireland

James Vassallo et al. Acta Paediatr. 2023 Jan.

Abstract

Aim: Triage is key to effective management of major incidents, yet there is scarce evidence surrounding the optimal method of paediatric major incident triage (MIT). This study aimed to derive consensus on key components of paediatric MIT among healthcare professionals responsible for triage during paediatric major incidents.

Methods: Two-round online Delphi consensus study delivered July 2021-October 2021, including participants from pre-hospital and hospital specialities responsible for triage during paediatric major incidents. A 5-point Likert scale was used to determine consensus, set a priori at 70%.

Results: 111 clinicians completed both rounds; 13 of 17 statements reached consensus. Positive consensus was reached on rescue breaths in mechanisms associated with hypoxia or asphyxiation, mobility assessment as a crude discriminator and use of adult physiology for older children. Whilst positive consensus was reached on the benefits of a single MIT tool across all adult and paediatric age ranges, there was negative consensus in relation to clinical implementation.

Conclusions: This Delphi study has established consensus among a large group of clinicians involved in the management of major incidents on several key elements of paediatric major incident triage. Further work is required to develop a triage tool that can be implemented based on emerging and ongoing research and which is acceptable to clinicians.

Keywords: life-saving interventions; major incidents; paediatrics; triage.

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