Pediatric early warning score versus a paediatric triage tool in the emergency department: A reliability study.

Aim: In the paediatric emergency department (PED), it is important to correctly prioritize children for physician assessment. The pediatric early warning score (PEWS), although not a triage tool, is often used for PED triage. The scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) is a reliability tested triage tool. We aimed to compare PEWS and RETTS-p in a Norwegian PED.

Design: A reliability study.

Methods: The PED nurse routinely did PEWS observations, while the principal investigator concomitantly made RETTS-p observations. Inter-tool agreement was calculated for the complete PEWS and RETTS-p and for vital signs scores, disregarding the RETTS-p emergency symptoms and signs (ESS).

Results: Rapid Emergency Triage and Treatment System-pediatric assigned a higher urgency than PEWS. The inter-tool agreement between PEWS and RETTS-p was low (weighted kappa [95% confidence interval [CI] = 0.32 [0.24-0.40]]). Weighted kappa (95% CI) was 0.50 (0.41-0.59) for PEWS and RETTS-p without ESS, indicating that PEWS is not equivalent to five-level triage tools.