Aspects of triage for infants: a narrative review

Abstract

Infants under 1 year old frequently visit the general practitioner with acute illnesses. Assessing the severity of illness in this group can be challenging as signs and symptoms may be observed in both sick and healthy infants. Current triage systems are primarily designed for older children and adults and have been validated mainly in high-prevalence settings, such as emergency departments. As a result, these systems often result in undertriage, which can lead to delayed treatment and adverse outcomes.

Conclusion: This review reports the existing triage and scoring systems, currently used in infants. We discuss the strengths and limitations of this systems. Furthermore, we explore how the integration of clinical features with vital signs, such as heart rate and oxygen saturation, can improve the accuracy of triage for infants. The BabyCheck, validated for use in primary care for infants under 6 months of age, and the use of pulse oximetry offer promising improvements. Further research is essential to develop and validate an optimal triage system for infants under one year of age in the general practitioner setting.

What is known: • Current triage systems are widely used in emergency departments but show limitations, especially when applied to infants. • These existing triage systems often result in undertriage or overtriage, which can lead to either unnecessary healthcare utilization or delayed treatment for serious conditions.

What is new: • Combining vital signs such as heart rate and oxygen saturation with clinical features, may improve the accuracy of triage systems for infants.

Keywords: Infants; Primary care; Triage; Vital signs.