Skip to main content
SpringerLink
Log in

Enquête nationale sur les méthodes de triage aux urgences pédiatriques

National survey of triage methods in pediatric emergency departments

  • Article Original / Original Article
  • Published:
Annales françaises de médecine d'urgence

Résumé

Objectif

L’afflux simultané des patients aux urgences pédiatriques ainsi que la variabilité de la sévérité des cas nécessitent l’utilisation d’un processus de triage afin de déterminer la priorité de soins en fonction de la gravité des cas. À ce jour, il n’existe aucun état des lieux sur les pratiques de triage utilisées dans les services d’urgences pédiatriques en France. L’objectif de cette étude était de faire un état des lieux des pratiques de triage dans les services d’urgences pédiatriques en France.

Matériel et méthodes

Un total de 112 questionnaires a été envoyé par voie postale aux médecins responsables des services d’urgences pédiatriques en mai 2009.

Résultats

Sur les 112 services d’urgences pédiatriques, 93 (83 %) ont répondu: 61 (66 %) avaient un triage infirmier, 45 (48 %) avaient une infirmière organisatrice de l’accueil (IOA) qui avait souvent peu d’expérience et était peu formée. Le triage était fait de façon intuitive dans 29 (48 %) services, avec un outil validé dans 9 (15 %) services et avec un outil local dans 23 (38 %) services. L’efficacité de leur méthode de triage a été évaluée dans 12 (20 %) services. La plupart des services ont déclaré utiliser un triage avec quatre niveaux associés à un délai de prise en charge.

Conclusion

Ces résultats sont en deçà des recommandations de la SFMU. La mise en place d’un outil de triage semble essentielle pour améliorer les méthodes de triage.

Abstract

Aims

The simultaneous visits of patients to the pediatric emergency department (ED) requires the use of a triage process to determine the priority of care for incoming patients based on the severity of their illnesses. To date, there is no data on the different triage methods used in the pediatric ED in France. The main objective was to describe triage practices in the pediatric ED in France.

Procedure

112 questionnaires were sent by postal mail to physicians responsible for pediatric ED in May 2009.

Results

From the 112 departments that were invited, 93 (83%) accepted to participate: 61 (66%) used a triage method in children. A triage-nurse was declared in 45 (48%) centers. Most of the time this nurse had little experience and had not received specific triage training. The triage was done in an intuitive way in 29 (48%) departments, with a validated scale in 9 (15%) departments and with a local scale in 23 (38%) departments. Responders reported that in 12 (20%) departments the adequacy and effectiveness of nurse triage practice had been assessed. Most departments declared to use four levels of triage associated with a delay of care.

Conclusion

These results do not meet the French SFMU recommendations. The implementation of a validated tool to help with pediatric triage seems essential to ED to improve the quality of triage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Australasian college for emergency medicine (2000) Guidelines on the implementation of the Australasian triage scale in emergency department. Report No.: G24 https://www.acem.org.au/getattachment/d19d5ad3-e1f4-4e4f-bf83-7e09cae27d76/G24-Implementation-of-the-Australasian-Triage-Scal.aspx, dernier accès le 15/09/2014

    Google Scholar 

  2. Green NA, Durani Y, Brecher D, et al (2012) Emergency severity index version 4: a valid and reliable tool in pediatric emergency department triage. Pediatr Emerg Care 28:753–7

    Article  PubMed  Google Scholar 

  3. Gouin S, Gravel J, Amre DK, Bergeron S (2005) Evaluation of the paediatric Canadian triage and acuity scale in a pediatric ED. Am J Emerg Med 23:243–7

    Article  PubMed  Google Scholar 

  4. Van Veen M, Steyerberg EW, Ruige M, et al (2008) Manchester triage system in paediatric emergency care: prospective observational study. BMJ 337:a1501

    Article  Google Scholar 

  5. Taboulet P, Moreira JP, Fontaine JP, et al (2007) La Classification infirmière des malades aux urgences (CIMU): fiabilité et précision de la V2. JEUR 20:45–6

    Google Scholar 

  6. Société française de médecine d’urgence SFMU (2004) Référentiel IOA. www.sfmu.org/documents/ressources/referentiels/ioa2004.pdf, dernier accès le 02/09/2014

    Google Scholar 

  7. Groupe francophone de réanimation et urgences pédiatriques GFRUP (2004) Annuaire des Urgences Pédiatriques. www.gfrup.com/gfrup_annuaire_urgence_rapide.htm, dernier accès le 13/01/2014

    Google Scholar 

  8. Société française de médecine d’urgence SFMU (2014) Le triage en structure des urgences. Recommandations formalisées d’experts. Ann Fr Med Urgence 4:196–200

    Article  Google Scholar 

  9. Roupie E, Santin A, Hervé J, Lejonc JL (2001) Modalités du triage aux urgences: Résultats d’une enquête multicentrique. JEUR 14:63 (Abstract)

    Google Scholar 

  10. Hue V, Dubos F, Pruvost I, et al (2011) Organisation et moyens de l’accueil des urgences pédiatriques: enquête nationale française en 2008. Arch Pediatr 18:142–8

    Article  CAS  PubMed  Google Scholar 

  11. Bergeron S, Gouin S, Bailey B, et al (2004) Agreement among pediatric health care professionals with the pediatric Canadian triage and acuity scale guidelines. Pediatr Emerg Care 20:514–8

    Article  PubMed  Google Scholar 

  12. Gravel J, Manzano S, Arsenault M (2009) Validity of the Canadian paediatric triage and acuity scale in a tertiary care hospital. CJEM 11:23–8

    PubMed  Google Scholar 

  13. Gravel J, Gouin S, Goldman RD, et al (2012) The Canadian triage and acuity scale for children: a prospective multicenter evaluation. Ann Emerg Med 60:71–7.e3

    Article  PubMed  Google Scholar 

  14. Gravel J, Fitzpatriageck E, Gouin S, et al (2013) Performance of the Canadian triage and acuity scale for children: a multicenter database study. Ann Emerg Med 61:27–32.e3

    Article  PubMed  Google Scholar 

  15. Roukema J, Steyerberg EW, van Meurs A, et al (2006) Validity of the Manchester triage system in paediatric emergency care. Emerg Med J 23:906–10

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Van der Wulp I, van Baar ME, Schrijvers AJ (2008) Reliability and validity of the Manchester triage system in a general emergency department patient population in the Netherlands: results of a simulation study. Emerg Med J 25:431–4

    Article  PubMed  Google Scholar 

  17. Seiger N, van Veen M, Steyerberg EW, et al (2013) Accuracy of triage for children with chronic illness and infectious symptoms. Pediatrics 132:e1602–8

    Article  Google Scholar 

  18. Seiger N, van Veen M, Almeida H, et al (2014) Improving the Manchester triage system for pediatric emergency care: an international multicenter study. PloS One 9:e83267

    Article  Google Scholar 

  19. American College of Emergency Physicians (2008) Emergency department crowding: high-impact solutions. www.acep.org/workarea/DownloadAsset.aspx?id=50026, dernier accès le 25/06/2014

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service des urgences pédiatriques, hôpital Armand Trousseau, AP-HP, 26 avenue du Dr Arnold Netter, F-75012, Paris, France

    E. Courtois, R. Carbajal & C. Galeotti

  2. Université Pierre et Marie Curie, 4 place Jussieu, F-75005, Paris, France

    R. Carbajal

Authors
  1. E. Courtois
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Carbajal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Galeotti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Courtois.

Electronic supplementary material

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Courtois, E., Carbajal, R. & Galeotti, C. Enquête nationale sur les méthodes de triage aux urgences pédiatriques. Ann. Fr. Med. Urgence 5, 3–8 (2015). https://doi.org/10.1007/s13341-014-0477-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13341-014-0477-4

Mots clés

Keywords

Search

Navigation