Improvements of Paediatric Triage at the Emergency Department

Abstract

__Abstract__ The practice of triage, originated from the French word “trier” which means to sort, was conceived around 1792 by Baron Dominique-Jean Larrey, Surgeon in Chief to Napoleon’s Imperial Gard. In these days, triage was used to identify soldiers whose injuries were readily treatable in order to return them to battlefield at the earliest opportunity. In 1846, the British naval surgeon John Wilson was the first who argued that treatment should be given first to patients who need immediate and potentially successful treatment. During World War I, the introduction of new weapons created an unprecedented number of potentially treatable mass casualties. This led to a wide introduction of the term “triage” and to a new definition of its concept, in which triage was not only aimed at sorting treatable patients from untreatable patients, but also took into account the complexity of treatable patients in order to save as much patients as possible. Nowadays, triage aims to prioritise patients according to their medical presentation in situations with modest scarcity of health care resources. This scarcity of resources is not only present at the military battlefield or in case of mass casualties and disasters, but can also occur at the emergency department (ED) or in the hospital settings with limited numbers of beds such as the intensive care unit. Although all these settings have distinguishing features, each requires the presence of a trained health care worker (“triage nurse”) to assess the patient’s medical needs, and an established system or plan to determine patient’s priority