Pediatric Disaster Triage

El Tawil C, Bergeron A, Khalil E. A scoping review of pediatric mass-casualty incident triage algorithms. Disaster medicine and public health preparedness. 2023;17:e317.

Objective
For the pediatric population, there is no consensus on which triage system to use for mass-casualty incidents (MCI). A scoping review was conducted to identify the most accurate triage system for pediatric patients in MCIs.

Methods
MEDLINE, Embase, CINAHL, and The Cochrane CENTRAL Register of Controlled Trials, as well as Scopus, Global Health, Global Health Archive were searched for relevant studies that were divided into 3 categories: accuracy of a single system, comparison of 2 or more primary triage system and comparison of secondary triage systems. Grey literature was also searched.

Results
996 studies were identified from which 18 studies were included. Systems studied were found to have poor inter-rater reliability, had a low level of agreement between providers, had missed critically ill patients or were not externally validated. 11 studies compared pediatric MCI triage algorithms using different strategies and the most accurate algorithm was not identified. A recently developed secondary triage system, specifically for pediatric patients, was found to perform better than the comparison triage system.

Conclusion
Although some algorithms performed better than others, no primary triage algorithm was accurate enough for the pediatric population. However, only 1 secondary triage algorithm was found to be superior to the others.


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