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J Korean Soc Emerg Med > Volume 30(1); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(1): 69-76.
발열 소아 환자의 한국형 응급환자 분류도구에서의 고려사항: 증상 발현 시간
오원철 , 노현
순천향대학교 부천병원 응급의학과
Consideration in Korean Triage and Acuity Scale for febrile pediatric patients: symptom duration
Won Cheol Oh , Hyun Noh
Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
Correspondence  Hyun Noh ,Tel: 032-621-5119, Fax: 032-621-6560, Email: dingii@hanmail.net,
Received: July 8, 2018; Revised: September 22, 2018   Accepted: October 1, 2018.  Published online: February 28, 2019.
ABSTRACT
Objective:
In the Korean Triage and Acuity Scale (KTAS), the triage of febrile pediatric patients is classified mainly by measuring the vital signs but it has limitations. Therefore, this study was conducted assuming that a better result can be obtained using the duration of fever when triaging a febrile pediatric patient.
Method:
If febrile pediatric patients satisfy the following four rules, the triage level was downgraded and it was defined as the modified Korean Triage and Acuity Scale (mKTAS) and compared with KTAS: age>3 months; alert mental status; patients who visit according to disease; and onset<24 hours.
Results:
The total and intensive care unit (ICU) admission rate was highest in triage level 2 in both KTAS and mKTAS (P<0.001). The length of stay in the febrile pediatric patients increased from triage level 1 to 5 in both KTAS and mKTAS. Resource use also decreased from triage level 1 to 5 in both KTAS and mKTAS. In particular, mKTAS has a better tendency than KTAS. Overall, there was a difference in the total admission rate and ICU admission rate, length of stay, and resource use between KTAS and mKTAS, but there was no significant clinical significance.
Conclusion:
If the KTAS level is down-triaged in febrile pediatric patients who are alert and 3 months or older and within 24 hours of symptom onset, there would be no significant clinical differences in the rates of admission, length of stay, and resource use. The duration of fever needs to be considered in triaging febrile pediatric patients.
Key words: Fever; Pediatrics; Triage
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