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Cathy Almond
process of triage.
can ascertain whether the child's rate is too fast or too slow.
It is important to know normal age ranges and therefore
recognise abnormal.
You will also note signs of respiratory distress, e.g. tracheal tug,
decision.
documented evidence.
Circulation
looks well, they are at the lower end of the scale. An unwell
Airway
suspected if:
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Disability
better indicator of how well or unwell they are, rather than the
cause of the fever that will determine the child's outcome, not
equipment.
who is quiet and listless, often falling asleep when left alone,
and that therefore fever is bad. ''7 Literature suggests that giving
reading, and few young children will remain still long enough
thirds of the child's upper arm or leg; a variety of sizes are not
intervention.
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2. Durren, M 1992 'Clinical Notebook Getting the most from pulse oximetry' in
Journal of Emergency Nursing 18(4) pp 340-342
4. Keddington, R.K. 1998 A triage vital sign policy for a children's hospital
emergency deparunent in Journal of Emergency Nursing 24 pg 189-192
5. LetiziaM and Janusek L 1994 'The self-defense mechanism of fever' in MedSurg
Nursing 3(5) pp 373-377
6. Nelson D 1998 'Pediatric Update Emergency treatment of fever phobia' in Journal
of Emergency Nursing 24(4) pp 83 84
7. Shan, F 1995 'Paracetamol: use in children' in Australian Prescriber 18(2)
pp 33-34
Development
There is very little time at triage to develop a rapport with
children. Having an understanding of basic growth and
development will enhance knowledge of expected normal
behaviour and therefore simplify the triage process. Neonates'
Conclusion
Nurses attend to vital signs in paediatrics because they are
afraid of 'missing something'. Those new to triage require
objective reassurance that they allocated the appropriate triage
category. I believe we need to change our thinking and update
triage training programs. We need to rely less on machines and
more on observation. A sick child is often observable. Placing a
hand on the child's head is sufficient to tell whether the child
is hot or not. "Vital signs are not infallible indicators. ''4
The triage process - from the initial assessment to the triage
decision - should take no longer than five minutes. 9 The time
taken to gain a child's trust and co-operation means
ascertaining baseline vital signs within this time frame can be
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