1.2 Summary of steps in emergency triage assessment and treatment
Steps in emergency triage assessment and treatment are summarized in the charts on pp. 5–17.
First check for emergency signs in three steps:
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Step 1. Check whether there is any airway or breathing problem; start immediate treatment to restore breathing. Manage the airway and give oxygen.
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Step 2. Quickly check whether the child is in shock or has diarrhoea with severe dehydration. Give oxygen and start IV fl uid resuscitation. In trauma, if there is external bleeding, compress the wound to stop further blood loss
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Step 3. Quickly determine whether the child is unconscious or convulsing. Give IV glucose for hypoglycaemia and/or an anti-convulsant for convulsing.
If emergency signs are found:
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Call for help from an experienced health professional if available, but do not delay starting treatment. Stay calm and work with other health workers who may be required to give the treatment, because a very sick child may need several treatments at once. The most experienced health professional should continue assessing the child (see Chapter 2, p. 41), to identify all underlying problems and prepare a treatment plan.
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Carry out emergency investigations (blood glucose, blood smear, haemoglobin [Hb]). Send blood for typing and cross-matching if the child is in shock, appears to be severely anaemic or is bleeding signifi cantly.
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After giving emergency treatment, proceed immediately to assessing, diagnosing and treating the underlying problem.
If no emergency signs are found, check for priority signs:
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Tiny infant: any sick child aged < 2 months
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Temperature: child is very hot
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Trauma or other urgent surgical condition
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Pallor (severe)
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Poisoning (history of)
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Pain (severe)
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Respiratory distress
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Restless, continuously irritable or lethargic
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