• M A Robertson and E M Molyneux.
• Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi.
• Arch. Dis. Child. 2001 Sep 1; 85 (3): 208-13.

AimTo assess guidelines for the emergency triage, assessment, and treatment (ETAT) of sick children presenting to hospitals in the developing world. This study pretested the guidelines in Malawi, assessing their performance when used by nurses compared to doctors trained in advanced paediatric life support (APLS).MethodsTriage was performed simultaneously by a nurse and assessing doctor on 2281 children presenting to the under 5s clinic. Each patient was allocated one of three priorities, according to the ETAT guidelines. Any variation between nurse and assessor was recorded on the assessment forms.ResultsNurses identified 92 children requiring emergency treatment and 661 with signs indicating a need for urgent medical assessment. One hundred and forty two (6.2%) had different priorities allocated by the APLS trained doctor, but these children did not tend to need subsequent admission. Eighty five per cent of admissions were prioritised to an emergency or urgent category.ConclusionAlthough there are no gold standards for comparison the ETAT guidelines appear to reliably select out the majority of patients requiring admission.

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