Triaging of acutely ill children transported by ambulance

Abstract

Background: The Western Norway Regional Health Authority uses SATS Norge (SATS-N), a modified version of the South African Triage Scale, in all accident and emergency departments (A&E) and ambulance services in the region. The purpose of the study was to examine the validity of the paediatric component of SATS-N used for children transported to hospital by ambulance for emergency medical assistance.

Material and method: We conducted a retrospective observational study which included all children in the age group 0-14 years, admitted by ambulance to A&E at Haukeland University Hospital for emergency medical assistance in the period from January to June 2020. The five triage levels in SATS-N were dichotomised to high triage level (the two highest triage categories) or low triage level (the three lowest triage categories). Sensitivity was calculated as the proportion of patients assigned to the high triage level among those who were directly transferred from A&E to a high dependency unit, and specificity as the proportion of patients assigned to the low triage level among those who were not directly transferred to a high dependency unit.

Results: Of a total of 303 patient transports, 270 (89 %) were triaged in the ambulance and 243 (80 %) in the A&E. In the pre-hospital and A&E settings, the sensitivity of SATS-N was 96 % and 88 %, and specificity was 46 % and 60 %, respectively.

Interpretation: For children admitted to hospital by ambulance, SATS-N had high sensitivity and low specificity for identifying patients who needed to be directly transferred from A&E to a high dependency unit.