P0173 / #868: CAN A TELEPHONE TRIAGE TOOL AID DECISION MAKING AND PRIORITISATION OF CRITICALLY UNWELL CHILDREN NEEDING TRANSFER TO PICU?

Abstract

Aims & Objectives: To assess whether a telephone triage tool can be developed to aid decision making and prioritisation of critically unwell children requiring transfer to a paediatric intensive care unit (PICU) by a retrieval team. Methods: Using paediatric early warning (PEWS) scores and goal directed therapy parameters; a draft severity/triaging scoring system was developed by a group of clinicians at a well-established regional paediatric transport service. 100 telephone referrals were retrospectively triaged by 2 blinded clinicians independently using the new triage tool. Notes were selected by electronic randomisation and each referral scored on parameters such as fast track need for intensive care (e.g. duct dependent lesion, need for ECMO etc), PEWS, acid-base status, fluid resuscitation and level of consciousness. Scores were compared with set patient outcomes previously identified as need for transport to PICU, number of organ support required and length of stay on PICU. Further analysis into association with inotrope score and PIM3 score are ongoing. Results: showed that the scores between the two clinicans correlated but it did not show any association between the triage score and identified patient outcome. Patients requiring advice only and no transfer scored higher than those requiring transfers to PICU, only 32% of the referral required transfer (23% to PICU and 9% for tertiary opinions). 51% improved in the DGH with advice only and 17% excluded. Conclusions: At current the triage tool does not predict or help prioritise need for transfer but further analysis is needed using parameters such as inotrope scores and PIM3 scores