Irish Children's Triage System: Overdose or Poisoning

The Irish Children's Triage System is used to triage pediatric patient coming to the Emergency Department.

Patient selection: overdose or poisoning

Shared parameters:

(1) abnormal age-related vital signs

(2) shock

(3) Glasgow coma scale

(4) substance use

(5) pain

(6) blood glucose

(7) duration

(8) history

Parameters	Findings	Category
abnormal vital signs	category 1	1
	category 2	2
	category 3	3
shock	uncompensated	1
	compensated	2
	none	5
Glasgow coma scale	<= 12	1
	13 or 14	2
	15	5
substance use	high toxicity	2
	moderate toxicity	3
	low toxicity	4
	none	5
pain	severe (VAS >= 7)	2
	moderate (VAS 4-6)	3
	mild (1 to 3)	4
	none	5
blood glucose	<= 2.7 mmolo/L (hypoglycemia)	2
	2.8 to 3.4 mmol/L	3
	> 3.4 mmol/L	5
duration	less than 48 hours (recent) or acute symptoms	4
	> 48 hours without acute symptoms	5
history or mechanism	significant	2
	inconsistent with findings	3
	consistent	5

where:

• Hyperglycemia is not covered but diabetic ketoacidosis can be triggered by poisoning.

Other Parameters	Category
airway compromise	1
respiratory failure/arrest	1
currently seizing	1
ingestion of unknown substance	2
ingestion of multiple substances	2
intentional self-harm	2
altered work of breathing (increase or decrease)	2
cardiac arrhythmia	2
altered blood pressure (hyper or hypotension)	2
persistent vomiting	3

The final triage category is MIN(triage category for all of the parameters).

If the there was intentional self-harm, then triage for psychosocial problems should be performed.

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