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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): 83-93.
한국형 응급환자 분류도구의 소아 적용을 위한 델파이 조사 연구
노현1 , 정구영2, 안기옥3, 김자경4, 손희정5 , 조희숙6
1순천향대학교 부천병원 응급의학과
2이화여자대학교 의과대학 응급의학교실
3명지병원 응급의학과
4강원대학교 의학전문대학원 소아청소년과학교실
5강원대학교 의학전문대학원 마취통증의학교실
6강원대학교 의학전문대학원 의료관리학교실
A Delphi study for the application of Korean Triage and Acuity Scale to children
Hyun Noh1 , Koo Young Jung2, Ki Ok Ahn3, Ja Kyoung Kim4, Hee Jeong Son5 , Heui Sug Jo6
1Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
2Department of Emergency Medicine, Ewha Womans University School of Medicine, Seoul, Korea
3Department of Emergency Medicine, Myongji Hospital, Goyang, Korea
4Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
5Department of Anesthesiology and Pain Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
6Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
Correspondence  Heui Sug Jo ,Tel: 033-250-8802, Fax: 033-259-5635, Email: joheuisug@gmail.com,
Received: July 16, 2018; Revised: September 21, 2018   Accepted: November 2, 2018.  Published online: February 28, 2019.
ABSTRACT
Objective:
We investigated the opinions of experts to identify problems and prepare an improvement plan when applying the Korean Triage and Acuity Scale (KTAS) to pediatric patients in the emergency department.
Method:
The experts comprised 15 researchers at a pediatric emergency center designated by the Ministry of Health and Welfare and research team members of the Korean Society of Pediatric Emergency Medicine. The first survey was an open-ended question about the problems, application results, and remedies of applying KTAS to children through email. The problems were categorized by topic, and degree of agreement was presented using a 9-point Likert scale.
Results:
In the first survey, 67% of experts participated and 18 problems were identified. In the second survey, 73% of experts participated and eight problems were identified in four categories, validity, reliability, feasibility and other opinions. All experts pointed out that resources were not considered during pediatric triage in the KTAS. Ninety-one percent of experts said that peak expiratory flow rate measurement and Glasgow Coma Scale evaluation were unlikely to be feasible. Moreover, 91% experts were concerned that the triage level could be distorted if KTAS was interlocked with medical costs. Eighty-two percent of the respondents pointed to the high triage result of febrile children and the difference in pain score between the evaluators, etc.
Conclusion:
Based on the problems pointed out by experts and the reality of Korea’s emergency departments, it is necessary to consider revision of KTAS for children.
Key words: Triage; Child; Emergencies
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