• M Twomey, B Cheema, H Buys, K Cohen, A de Sa, P Louw, M Ismail, H Finlayson, C Cunningham, and A Westwood.
• Division of Emergency Medicine, University of Cape Town, South Africa. micheletwomey@gmail.com
• S. Afr. Med. J. 2013 May 1;103(5):304-8.

ObjectiveTo validate a revised version of the paediatric South African Triage Scale (SATS) against admission as a reference standard and compare the sensitivity of triage using: (i) clinical discriminators; (ii) an age-appropriate physiological composite score; and (iii) a combination of both.MethodsA prospective cohort study was undertaken validating the revised paediatric SATS against outcome markers of children at six emergency centres during a 2-month period in 2011. The primary outcome marker was the proportion of children admitted. Validity indicators including sensitivity (Se), specificity, positive predictive value and negative predictive value (NPV) were used to estimate the validity. Associated percentages for over-/under-triage were used to further assess practical application of the paediatric SATS.ResultsA total of 2 014 children were included. The percentage of hospital admissions increased with an increase in the level of urgency from 5% in the non-urgent patients to 73% in the emergency patients. The data demonstrated that sensitivity increased substantially when using the SATS, which is a combination of clinical discriminators and the Triage Early Warning Score (TEWS) (Se 91.0%, NPV 95.3%), compared with use of clinical discriminators in isolation (Se 57.1%, NPV 86.3%) or the TEWS in isolation (Se 75.6%, NPV 89.1%).ConclusionThe results of this study illustrate that the revised paediatric SATS is a safe and robust triage tool.

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