Clinical trial NCT00807352: The Canadian Triage and Acuity Scale for Children; A Prospective Multi-Center Evaluation.
Official title: The Canadian Triage and Acuity Scale for Children; A Prospective Multi-Center Evaluation.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Triage
Pediatrics
Keywords: Triage
Pediatrics
Emergency Department
Lead sponsor: St. Justine's Hospital
Sponsor class: OTHER
Collaborators: name: SickKids Foundation
name: Canadian Institutes of Health Research (CIHR)
First posted: 2008-12-11
Enrollment: 1464
Sex: ALL
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All children presenting to a pediatric emergency department

Brief summary: The aim of this study is to evaluate the validity and the reproducibility of the canadian triage and acuity scale when applied by regular nurses for the triage of children in the Emergency Department.

Detailed description: The role of triage in the Emergency Department (ED) is to assign high priority to patients who need urgent care while identifying patients that may be able to wait safely. The Canadian Triage and Acuity Scale (CTAS) is a triage tool constructed from a consensus of experts that is universally used in Canada. Until now, there has been no evaluation of the validity of the tool for children in a clinical context. Also, its inter-rater reproducibility has not been evaluated. The expected implementation of a revised version of the Canadian triage tool in 2008 would be an ideal moment to evaluate its validity and reproducibility. Specific objective: 1. To evaluate the validity of the CTAS for children visiting a pediatric ED and 2. To measure the inter-rater agreement for nurses using the CTAS in these settings.

Eligibility criteria: Inclusion Criteria:

* Every patient younger than 18 years old that presents to the ED will be eligible except for those that need to go directly to the resuscitation room (triage level 1)

Exclusion Criteria:

* For ethical reasons, patients that need an immediate treatment will not be recruited in the study.
* Patients for whom an informed consent could not be obtained (example: insurmountable language barriers) will not be included.

Primary outcomes:
measure: The inter-rater agreement between the two nurses measured by the weighted Kappa score
timeFrame: 15 minutes
measure: The correlation between triage level and the hospitalisation rate
timeFrame: 1 day
Secondary outcomes:
measure: The correlation between triage level and admission to the intensive care unit
timeFrame: 1 day
measure: The correlation between triage level and length of stay in the ED after being seen by a physician
timeFrame: 1 day
measure: The correlation between triage level and resources use
timeFrame: 1 day
Other outcomes:
Locations:
city: Calgary
country: Canada
facility: Alberta Children's Hospital
state: Alberta
city: Edmonton
country: Canada
facility: Stollery Children's Hospital
state: Alberta
city: Vancouver
country: Canada
facility: BC Children's and Women's Hospital
state: British Columbia
city: Halifax
country: Canada
facility: IWK Heath Centre
state: Nova Scotia
city: London
country: Canada
facility: Children's Hospital of Western Ontario
state: Ontario
city: Ottawa
country: Canada
facility: Children's Hospital of Eastern Ontario
state: Ontario
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
city: Montreal
country: Canada
facility: CHU Sainte-Justine
state: Quebec
city: Quebec
country: Canada
facility: Centre hospitalier de l'Université Laval
Study officials:
affiliation: St. Justine's Hospital
name: Jocelyn Gravel, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Gravel J, Gouin S, Manzano S, Arsenault M, Amre D. Interrater agreement between nurses for the Pediatric Canadian Triage and Acuity Scale in a tertiary care center. Acad Emerg Med. 2008 Dec;15(12):1262-7. doi: 10.1111/j.1553-2712.2008.00268.x. Epub 2008 Oct 17.
citation: Gravel J, Gouin S, Goldman RD, Osmond MH, Fitzpatrick E, Boutis K, Guimont C, Joubert G, Millar K, Curtis S, Sinclair D, Amre D. The Canadian Triage and Acuity Scale for children: a prospective multicenter evaluation. Ann Emerg Med. 2012 Jul;60(1):71-7.e3. doi: 10.1016/j.annemergmed.2011.12.004. Epub 2012 Feb 2.