Triage of children with headache at the ED: a guideline implementation study

Balossini, Veronica; Zanin, Anna; Alberti, Corinne; Freund, Yonathan; Decobert, Marion; Tarantino, Antonella; La Rocca, Maria; Lacroix, Laurence Elisabeth; Spiri, Daniele; Lejay, Emilie; Armoogum, Priscilla; Wood, Chantal; Gervaix, Alain; Zuccotti, Gian Vincenzo; Perilongo, Giorgio; Bona, Gianni; Mercier, Jean-Christophe; Titomanlio, Luigi

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Title		Triage of children with headache at the ED: a guideline implementation study
Authors		Balossini, Veronica Zanin, Anna Alberti, Corinne Freund, Yonathan Decobert, Marion Tarantino, Antonella La Rocca, Maria Lacroix, Laurence Elisabeth Spiri, Daniele Lejay, Emilie Armoogum, Priscilla Wood, Chantal Gervaix, Alain Zuccotti, Gian Vincenzo Perilongo, Giorgio Bona, Gianni Mercier, Jean-Christophe Titomanlio, Luigi show all authors [1 - 18]
Published in		The American Journal of Emergency Medicine. 2013, vol. 31, no. 4, p. 670-5
Abstract		We present a multicenter validation of a modified Manchester Triage System (MTS) flowchart for pediatric patients who present with headache to the emergency department. A prospective observational study was conducted across 5 European pediatric emergency departments. The standard MTS headache flowchart and a modified MTS headache flowchart were tested in the participating centers, and results were compared with triage categories identified by either the physician at the end of the clinical examination or the reference classification matrix (RCM). Fifty-three patients were enrolled in the preimplementation phase and 112 in the postimplementation phase. When compared with physician's triage and RCM, the modified MTS flowchart demonstrated good sensitivity (79% and 70%, respectively), specificity (77% and 76%, respectively), and a high positive likelihood ratio (9.14 and 16.75, respectively) for the identification of low-risk children. Conclusions: Our modified headache flowchart is safe and reliable in pediatric emergency settings, especially for lower classes of urgency.
Keywords		Adolescent — Child — Child, Preschool — Emergency Service, Hospital — Female — Guideline Adherence — Headache/classification/etiology — Humans — Male — Prospective Studies — Triage/methods
Identifiers		DOI: 10.1016/j.ajem.2012.11.027 PMID: 23380115
Full text		Article (Published version) (311 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de pédiatrie
Research group		Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183)
Citation (ISO format)		BALOSSINI, Veronica et al. Triage of children with headache at the ED: a guideline implementation study. In: The American Journal of Emergency Medicine, 2013, vol. 31, n° 4, p. 670-5. https://archive-ouverte.unige.ch/unige:35599