Open AccessAbnormal ranges of vital signs in children in J apanese prehospital settings
Author(s) -
Nosaka Nobuyuki,
Muguruma Takashi,
Knaup Emily,
Tsukahara Kohei,
Enomoto Yuki,
Kaku Noriyuki
Publication year - 2015
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.139
Subject(s) - vital signs , triage , medicine , confidence interval , scale (ratio) , signs and symptoms , pediatrics , emergency medicine , anesthesia , cartography , geography
Aim The revised F ire S ervice L aw obliges each prefectural government in J apan to establish a prehospital acuity scale. The F oundation for A mbulance S ervice D evelopment ( FASD ) created an acuity scale for use as a reference. Our preliminary survey revealed that 32 of 47 prefectures directly applied the FASD scale for children. This scale shows abnormal ranges of heart rate and respiratory rate in young children. This study aimed to evaluate the validity of the abnormal ranges on the FASD scale to assess its overall performance for triage purposes in paediatric patients. Methods We evaluated the validity of the ranges by comparing published centile charts for these vital signs with records of 1,296 ambulance patients. Results A large portion of the abnormal ranges on the scale substantially overlapped with the normal centile charts. Triage decisions using the FASD scale of vital signs properly classified 22% ( n = 287) of children. The sensitivity and specificity for high urgency were as high as 91% (95% confidence interval, 82–96%) and as low as 18% (95% confidence interval, 16–20%). Conclusion We found there is room for improvement of the abnormal ranges on the FASD scale.