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Validity of the Canadian emergency department triage acuity scale respiratory rate and pulse rate reference ranges when applied to a Chinese population [Abstract]

Chan, S.S., Graham, C.A. and Rainer, Timothy 2012. Validity of the Canadian emergency department triage acuity scale respiratory rate and pulse rate reference ranges when applied to a Chinese population [Abstract]. Annals of Emergency Medicine 60 (4) , S136-S137. 10.1016/j.annemergmed.2012.06.420

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Abstract

Introduction: A previous study found that about half of the measured blood pressure, pulse rate and respiratory rate values in a population of healthy Chinese pre-school and school aged children fell outside the Advanced Pediatric Life Support (APLS) aged-based vital signs reference range. Study Objectives: To examine the validity of the Canadian emergency department Triage and Acuity Scale (CTAS) aged-specific respiratory rate and pulse rate reference ranges as applied to a Chinese population. Methods: Secondary analysis was performed on an existing database of vital signs measurements obtained from a population of healthy Chinese pre-school and school aged children. The volunteers were recruited from 8 kindergartens and 6 primary schools in Hong Kong, with their parents' informed written consent. Excluded from study were subjects who had symptoms of illness (eg, respiratory tract infection, gastroenteritis), subjects with known congenital or chronic conditions (eg, congenital heart disease, diabetes, asthma), and subjects who were on medication. Subjects belonging to the age-groups of 1-3 years, 6-years, and 10-years, the same age-group categorization used in the CTAS reference table for pulse rate and respiratory rate, were identified and selected for analysis. Results: There were 180 subjects aged 1-3 years (87 females), 145 subjects aged 6 years (57 females), and 129 subjects aged 10 years (59 females). For the 1-3 years age-group, the respiratory rate of 33.8% (95% CI, 27.1% to 41.3%) and the pulse rate of 7.7% (95% CI, 4.4% to 12.9%) of the subjects fell outside the CTAS reference ranges. For the 6-years age-group, the respiratory rate of 17.9% (95% CI, 12.2% to 25.3%) and the pulse rate of 13.1% (95% CI, 8.2% to 19.9%) of the subjects fell outside the CTAS reference ranges. For the 10-years age-group, the respiratory rate of 37.7% (95% CI, 29.7% to 46.9%) and the pulse rate of 21.7% of the subjects fell outside the CTAS reference ranges. Overall, the respiratory rate of 29.8% and pulse rate of 14.2% of healthy subjects fell outside the CTAS reference ranges, and would be classified as CTAS level III or above. The discrepancy is most evident in the 10-year age-group in which the respiratory rate of 35.7% and the pulse rate of 21.7% (95% CI, 15.1% to 30.0%) of subjects were above the CTAS normal range of 14-20/min and 60-90/min respectively. Conclusion: The respiratory rate and pulse rate reference ranges used for the triage of paediatric patients in Canadian emergency departments may have a tendency to misclassify ethnic Chinese patients to a higher priority (CTAS level III or above) of care.

Item Type: Article
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Additional Information: ACEP Research Forum 2012
Publisher: Elsevier
ISSN: 0196-0644
Last Modified: 04 Jun 2017 09:15
URI: http://orca-mwe.cf.ac.uk/id/eprint/92688

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