ABSTRACT
The practice of triage was conceived during the Napoleonic wars, with the aim of salvaging those soldiers whose injuries were readily treatable, returning them to the battlefield at the earliest opportunity. Literally, the word triage means "to sieve" or "to sort" (French trier), and those earlier battlefield principles have been refined and expanded to now encompass trauma and medical emergencies, with triage practiced in prehospital and hospital settings. To address the anatomical, physiological and developmental differences encountered when dealing with children, specific paediatric triage systems have also been developed, and this article discusses their merits.
Subject(s)
Child Health Services/organization & administration , Triage/organization & administration , Acute Disease/therapy , Ambulances , Child , Hotlines , Humans , Infant , State Medicine/organization & administration , Telephone , United Kingdom , Wounds and Injuries/therapyABSTRACT
BACKGROUND: Prescribing medication appropriate to a child's bodily dimensions is fundamental to paediatric emergency medicine. Mathematical formulae are frequently used in clinical practice to estimate children's weights. In 1995 the UK's paediatric reference data, describing age-related changes in bodily proportions (both weight and height), were updated and published. This study assesses the validity of using mathematical estimates, age-based estimates or length-based estimates of weight (the latter both compiled from this reference data) by comparison with actual physical measurements recorded in a paediatric clinic setting. METHODS: A prospective study was carried out in a paediatric outpatient setting recording age, weight and height for statistical comparison with these three possible methods. RESULTS: 544 children aged 0-11 years were recruited, with mean (SD) age, weight and height of 5.3 (2.9) years, 21.4 (10) kg and 108 (22) cm, respectively. CONCLUSIONS: Both length-based and age-based estimates of weight outperformed the currently accepted "gold standard" mathematical estimate when applied to children up to 11 years of age (approximately 35 kg). Length-based estimates were statistically superior, but the physical limitations and technical constraints posed when attempting to accurately measure a child's length in emergency environments may favour the simplicity of using the child's age against tables of growth chart reference data to provide an estimate of their weight.
