Triage, temperatura, frecuencia cardíaca y saturación de O 2, en la clasificación de pacientes en un servicio de urgencia pediátrico

Abstract

This study evaluates the association of Triage (Tr), body temperature (t) and Oxygen saturation (SatO 2) at the time of admission to a Pediatric Emergency Service (PES) with discharge home or hospitalization. Method: 1 863 patients admitted to a PES in June and July of 2007 were included, stratified by age (< 2 mo, 3-12 mo, 13-36 m, 37-60 mo, 61-120 mo, 121-187 mo). Chi Square test was used, screening for p < 0.05. Results: Hospitalization was most likely for children under 6 months old, (5.42, range 3.9-7.6), scoring Triage < 2 (6.9, range 4.7-10.2), or a Saturation level below 93% (23.68, range 14.6-38.3). No significant association was seen between fever and hospitalization (1.31, range 0.9-1.8). SatO 2 < 93% was associated to tachycardia in all ages (3.62, range 2.09-5.79), so did fever (6.74, range 5.07-8.67). Over half (51.8%) of children with fever showed tachycardia, 22.8% of afebrile cases were associated to this symptom. Discussion: Risk of hospitalization is higher if a child is younger than 6 months old, with Oxygen Saturation below 93% or Triage level < 2. Over 600 children presented tachycardia (33%); none progressed to Shock even with SatO 2 < 93% or Triage level < 2. Tachycardia, as an isolated sign, does not appear to be forecast significant hemodynamic change or need to be treated as such.