Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Prioritising paediatric emergencies and the predictive value of objective physiological parameters
- Zoe J Roberts, Joe Merola, Hugo Dowd (15 October 2008)
|
|
|||
|
Zoe J Roberts, SpR Paediatric Emergency Medicine University Hospital of Wales, Cardiff, Joe Merola, Hugo Dowd
Send response to journal:
|
Maconochie’s editorial on the use of the Manchester triage score in the paediatric population broaches a common dilemma. We know that there are a few sick children hidden among a lot of children with minor illness but how can we safely differentiate when we are under pressure to perform, train juniors, reduce inefficiencies and avoid duplication of work. With this in mind, we recently completed a retrospective study in the Paediatric Emergency Unit, University Hospital of Wales, Cardiff, looking at the predictive value of physiological parameters in children assessed at triage. We were interested to see whether those perceived to be ‘unwell’ could be accurately predicted as to the need for admission or discharge home on the basis of these observations. These children were categorised according to their presenting complaints, with a total of 506 recruited. Our results showed that all physiological parameters had a reasonably high negative predictive value (i.e. when within normal limits, this was a good prediction for discharge). However, most positive predictive values were generally quite low except that of central CRT, which showed a 100% PPV for most of the presenting complaints. The medical statisticians based at UHW have looked at our results but as expected state the need to recruit more numbers in order to attain statistical significance, ideally within a multi-centre context. We are keen to take such a study forward and would welcome interest from other centres in order to do so. Competing interests: None declared |
|||