The 2016 revisions have added 3 new CEDIS complaints, integrated components of the Obstetrical Triage and Acuity Scale (OTAS) to align our obstetrical special modifiers where possible, and added a postpartum complaint. The need to identify and adjust to the challenges of the increasing aging demographic has led to the publication of a separate review on applying CTAS to the geriatric population.
Key updates in this revision include messaging around the recognition that ED overcrowding both increases the need for effective triage, but can also add pressure to triage nurse acuity assignments. The ideal is to ‘stream’ patients to the most appropriate treatment space and not to the waiting room. Adult fever is now defined as >38oC to align with the SIRS criteria definition. For Paeds pulse and respiratory rate assessments, new 0-2 years graphs have been developed for easier interpretation. Newly born was added as a presenting complaint for babies born in or on the way to the ED. Button battery modifiers have been added to several foreign body complaints.
Since the original Paeds CTAS Implementation Guideline published in 2001, a standardized CEDIS complaint list was published. A revised CEDIS version in 2008 was published to be more inclusive of the diversity of adult and paediatric presentations and the paediatric complaints were included in the system based list rather than separated. The new implementation guideline clarifies the similarity of the process for adult and paediatric triage while recognizing some of the unique aspects of children’s presentations.
In conjunction with the 2008 CEDIS presenting complaint list revisions, the Adult CTAS Guideline has been revised. To understand the current content and implementation of adult CTAS, readers need to include the 2004 guideline revisions as the 2008 manuscript only identifies modifications to the 2004 paper, but does not repeat any of the content that is unchanged.
Following the publication of the CEDIS presenting complaint list in 2003 and experimentation with CTAS electronic decision support, the adult guidelines were revised to combine the complaints and standardized CTAS modifiers in a format compatible with computerization.