Vital Signs
Do observations of vital signs really indicate how sick a child is? - Would this be an effective triage tool?
Introduction
This assignment will look at papers that are relevant to the research question posed; it will consider their validity, scope of relevance and whether further research may be needed either to answer the question or to clarify aspects of research already completed.
Traditionally emphasis is placed on vital sign recording to indicate the severity of an illness, and with the advent of Paediatric Early or Advanced Warning Score systems (PEWS / PAWS) ( Monaghan 2005) there is now widespread use of these tools in the assessment of improving or worsening of the presenting illness. Tucker et al (2009) found PEWS were a reliable form of identifying children who are at risk of deterioration. Experientially it has been noted that a child may not have a change in these values initially and it is difficult to explain that ‘gut instinct’ is saying that the child is better or worse. Conversely some children who score highly on these systems are not unduly sick. In practice this has an impact on prioritising care in a busy paediatric assessment unit with less experienced staff having difficulty in recognising how ill the child potentially may or may not be.
For the purpose of this study, a review of research will be undertaken to see as to whether there is any robust evidence that shows their value in identifying and more significantly subsequently prioritising the management of a sick child.
Therefore a research question was formulated, asking if observations of vital signs in children really indicate how sick they are and are they effective in prioritising care.
A widely used triage system, the Manchester Triage System (MTS) (Mackway- Jones 2004) has noted flaws when used for children. The use of some triage systems that are also used for adults may yield false security; an example is if a category picked does not mention abdominal pain and
Introduction
This assignment will look at papers that are relevant to the research question posed; it will consider their validity, scope of relevance and whether further research may be needed either to answer the question or to clarify aspects of research already completed.
Traditionally emphasis is placed on vital sign recording to indicate the severity of an illness, and with the advent of Paediatric Early or Advanced Warning Score systems (PEWS / PAWS) ( Monaghan 2005) there is now widespread use of these tools in the assessment of improving or worsening of the presenting illness. Tucker et al (2009) found PEWS were a reliable form of identifying children who are at risk of deterioration. Experientially it has been noted that a child may not have a change in these values initially and it is difficult to explain that ‘gut instinct’ is saying that the child is better or worse. Conversely some children who score highly on these systems are not unduly sick. In practice this has an impact on prioritising care in a busy paediatric assessment unit with less experienced staff having difficulty in recognising how ill the child potentially may or may not be.
For the purpose of this study, a review of research will be undertaken to see as to whether there is any robust evidence that shows their value in identifying and more significantly subsequently prioritising the management of a sick child.
Therefore a research question was formulated, asking if observations of vital signs in children really indicate how sick they are and are they effective in prioritising care.
A widely used triage system, the Manchester Triage System (MTS) (Mackway- Jones 2004) has noted flaws when used for children. The use of some triage systems that are also used for adults may yield false security; an example is if a category picked does not mention abdominal pain and