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  • 1.  ESI in pediatric triage

    Posted 07-11-2024 10:47 AM

    Hey,

    I have been involved in a lot of pediatric triage/ESI discussions lately and because of that wanted to post this question to get info/resources/help/thoughts.

    What strategies have you found most successful when helping others apply the Emergency Severity Index (ESI) for pediatric patient triage in your ED?

    Would love to hear about your experiences and any innovative approaches you've developed to optimize the use of ESI in pediatric care.



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    Becca Mielke, BSN, RN, CPEN, TCRN

    RN Pediatric Emergency Care Coordinator (PECC) and Quality Champion

    Emergency Department
    Dell Children's Medical Center
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  • 2.  RE: ESI in pediatric triage

    Posted 07-15-2024 05:57 PM

    Hi, Becca! 

    Great question and this is something I have been working on as well. I recently accessed the ENA's 5th edition ESI handbook and thought I would share it with you too. I'll link it at the bottom. I've noticed in my own practice that the biggest thing is to know vital sign alterations for kiddos of all ages to understand what lies out of the expected range/ could elevate their ESI. It's also helpful to utilize the pediatric assessment triangle to see if the kid in front of you could be elevated based on their appearance, work of breathing, circulatory status. Also, it is helpful to know how different diseases present in kiddos (which of course comes with time, training, and practice). Knowing if a kiddo is vaccinated/unvaccinated/immunocompromised, etc. will all clue in to risks too. 

    The facility I work for does not have a policy that specifically addresses pediatric patients in triage, however, our practice is to get a chief complaint, weight in kg standard for all patients, full set of vital signs (including temp/BP (BP can be deferred in child <3y unless toxic in appearance), allergies, and assign an ESI based on this data. As I have been precepting new nurses to the department I have suggested using the PAT format in the triage narrative and have seen great decision-making even in our newer nurses by doing this and thus alerting the team to emergent situations and the need for intervention. 

    If possible, including your education or nursing support specialist if you have one may be helpful to get some sort of policy or procedure going to standardize the process for your team, but there are also many good resources like the handbook and ENPC. I'd love to hear what you come up with! 

    chrome-extension://bdfcnmeidppjeaggnmidamkiddifkdib/viewer.html?file=https://californiaena.org/wp-content/uploads/2023/05/ESI-Handbook-5th-Edition-3-2023.pdf



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    Madisyn Kephart BSN;RN
    Registered Nurse
    Wisconsin State Council
    Eau Claire WI
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    Original Message


  • 3.  RE: ESI in pediatric triage

    Posted 07-16-2024 11:58 AM
      |   view attached

    Hey Becca,

    I took the ENA triage class and read the handbook. Then I took that information and pediatric initial assessment and made a pediatric specific triage class. But for a quick reference, I attached the ESI for peds from the ENA. I think teaching normal pediatric vital signs, getting an accurate weight in kg, the pediatric assessment triangle, EMTALA laws, and what "resources" are, would be the highlights of what to teach for pediatric triage. I hope the document helps :) 



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    Amanda Yarber RN
    Peds Trauma Coordinator
    Tennessee State Council
    Johnson City TN
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    Attachment(s)

    docx
    ESI.docx   1.10 MB 1 version
    Original Message


  • 4.  RE: ESI in pediatric triage

    Posted 02-26-2025 10:42 AM

    Good afternoon!

    I know this post is a little older by now, but I wondered if you could possibly send me more information regarding the pediatric specific ESI/triage class that you came up with?  We are trying to get better clarification regarding this population to our triage nurses in order to make our processes smoother and more accurate.

    I appreciate any help you can provide!  

    My email is jane.m.wells14.mil@health.mil

    Jane Wells



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    Jane Wells RN
    Nurse
    Virginia State Council
    Newport News VA
    (407) 615-9386
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    Original Message


  • 5.  RE: ESI in pediatric triage

    Posted 02-27-2025 08:38 AM
    Edited by Becca Mielke 02-27-2025 08:39 AM

    Hello,

    I have developed an entire course for my nurse, but I also did a abbreviated webinar that is free!! It is part of the Texas Pediatric Readiness Project education series. Here is the link.

    https://utexas.app.box.com/v/texaspediatricreadinessproject/folder/245794636020

    This is the link for the Texas Pediatric Readiness Project:

    https://txena.org/texas-pediatric-readiness-improvement-project/



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    Becca Mielke, BSN, RN, CPEN, TCRN

    RN Pediatric Emergency Care Coordinator (PECC) and Quality Champion

    Emergency Department
    Dell Children's Medical Center
    ------------------------------

    Original Message


  • 6.  RE: ESI in pediatric triage

    Posted 02-27-2025 10:33 AM

    This is amazing.  Thank you so so much!  



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    Jane Wells RN
    Nurse
    Virginia State Council
    Newport News VA
    (407) 615-9386
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    Original Message