The Emergency Severity Index Version 4: Changes to ESI Level 1 and Pediatric Fever Criteria

Gilboy, Nicki; Tanabe, Paula; Travers, Debbie

doi:10.1016/j.jen.2005.05.011

Cited by 158 publications

(228 citation statements)

References 4 publications

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“…20,21 However, recent publications suggest that reference ranges for vital signs should be updated with new thresholds. [22][23][24] At present, conventional triage systems such as the MTS, 25,26 the Emergency Severity Index (ESI), 27 the pediatric Canadian Triage and Acuity Scale (PedCTAS), 28 and the Australasian triage Scale (ATS) 29 are used in the ED to allocate the patient' s acuity. In the MTS, PedCTAS, and ATS, trained triage nurses had to recognize patient' s signs and symptoms to allocate acuity.…”

Section: Discussionmentioning

confidence: 99%

“…25,26,28,29 In the ESI, the urgency categories are based on the need of life-saving interventions and resource use. 27 In all triage systems, vital signs are included to allocate urgency. However, the use of these vital signs differed from the use in PEWS scoring systems, because they are dichotomized into normal and abnormal for the ATS, PedCTAS , and ESI, and in the MTS, they were included as discriminators such as "shock," "abnormal pulse," and "increased work of breathing"; thus, values for abnormality in children were not provided.…”

Section: Discussionmentioning

confidence: 99%

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Validity of Different Pediatric Early Warning Scores in the Emergency Department

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Pediatric early warning scores (PEWS) for hospital inpatients have been developed to identify patients at risk for deterioration. Beyond triage, similar systems that identify ill patients and predict requirements for a higher level of care are needed in the emergency department. WHAT THIS STUDY ADDS:The validity of the different PEWS in pediatric emergency care patients has never been evaluated. This study showed that PEWS are capable of detecting children in need of ICU admission. abstract OBJECTIVE: Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED. METHODS:Ten different PEWS were evaluated in a large prospective cohort. We included children aged ,16 years who had presented to the ED of a university hospital in The Netherlands (200922012). The validity of the PEWS for predicting ICU admission or hospitalization was expressed by the area under the receiver operating characteristic (ROC) curves.RESULTS: These PEWS were validated in 17 943 children. Two percent of these children were admitted to the ICU, and 16% were hospitalized. The areas under the ROC curves for predicting ICU admission, ranging from 0.60 (95% confidence interval [CI]: 0.5720.62) to 0.82 (95% CI: 0.79-0.85), were moderate to good. The area under the ROC curves for predicting hospitalization was poor to moderate (range: 0.56 [95% CI: 0.55-0.58] to 0.68 [95% CI: 0.66-0.69]). The sensitivity and specificity derived from the ROC curves ranged widely for both ICU admission (sensitivity: 61.3%-94.4%; specificity: 25.2%-86.7%) and hospital admission (sensitivity: 36.4%-85.7%; specificity: 27.1%-90.5%). None of the PEWS had a high sensitivity as well as a high specificity.CONCLUSIONS: PEWS can be used to detect children presenting to the ED who are in need of an ICU admission. Scoring systems, wherein the parameters are summed to a numeric value, were better able to identify patients at risk than triggering systems, which need 1 positive parameter. Pediatrics 2013;132:e841-e850

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Validity of Different Pediatric Early Warning Scores in the Emergency Department

et al. 2013

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“…The ESI guidelines state that the interpretation of vital signs for allocating a patient to ESI categories 2 or 3 is up to the triage nurse, for example, a patient with disturbed vital signs does not automatically meet ESI level 2 criteria 11. For example, a patient who has a history of COPD and presents with an oxygen saturation of 89% might not meet ESI level 2 criteria.…”

Section: Methodsmentioning

confidence: 99%

Associations of the Emergency Severity Index triage categories with patients' vital signs at triage: a prospective observational study

Wulp

Rullmann

Leenen

et al. 2010

Emergency Medicine Journal

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“…We used ESI triage level as a marker for acuity. 21,22 To examine variation in patterns of parents' written communication by visit type and acuity, we used the Mann-Whitney U test given the nonparametric distribution of our data. For all analyses involving visit type, we used visit type determined by EMR review as the criterion standard.…”

Section: Primary Data Analysismentioning

confidence: 99%

A Content Analysis of Parents' Written Communication of Needs and Expectations for Emergency Care of Their Children

Hoppa

Porter²

2011

Pediatric Emergency Care

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The Emergency Severity Index Version 4: Changes to ESI Level 1 and Pediatric Fever Criteria

Cited by 158 publications

References 4 publications

Validity of Different Pediatric Early Warning Scores in the Emergency Department

Validity of Different Pediatric Early Warning Scores in the Emergency Department

Associations of the Emergency Severity Index triage categories with patients' vital signs at triage: a prospective observational study

A Content Analysis of Parents' Written Communication of Needs and Expectations for Emergency Care of Their Children

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