Triage Quick Reference Guide

Paediatric physiological discriminators (PPD)

Page last updated: 21 January 2013

The following tables provide the criteria for PPD, including disability.

PPD Category 1
Immediate
Category 2
Emergency
Within 10 minutes
Category 3
Urgent
within 30 minutes
Category 4
Semi-urgent
Within 60 minutes
Category 5
Non-urgent
Within 120 minutes
Airway Obstructed

Partially obstructed with severe respiratory distress
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Partially obstructed with moderate respiratory distress
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Partially obstructed with mildrespiratory distress
Patent Patent
Breathing Absent respiration or hypoventilation Respiration present Respiration present Respiration present Respiration present
Circulation
s/s dehydration *
Severe respiratory distress, e.g.
  • severe use of accessory muscles
  • severe retraction
  • acute cyanosis
Moderate respiratory distress, e.g.
  • moderate use of accessory muscles
  • moderate retraction
  • skin pale
Mild respiratory distress, e.g.
  • mild use of accessory muscles
  • mild retraction
  • skin pink
No respiratory distress, e.g.
  • no use of accessory muscles
  • no retraction
No respiratory distress, e.g.
  • no use of accessory muscles
  • no retraction
Circulation
s/s dehydration *
Absent circulation
Severe bradycardia, e.g. HR <60 in an infant
Circulation present Circulation present Circulation present Circulation present
Circulation
s/s dehydration *
Severe haemodynamic compromise, e.g.
  • absent peripheral pulses
  • skin pale, cold, moist, mottled
  • significant tachycardia
  • capillary refill >4 secs
Moderate haemodynamic compromise, e.g.
  • weak/thready brachial pulse
  • skin pale, cool
  • moderate tachycardia
  • capillary refill 2-4 secs
Mild haemodynamic compromise, e.g.
  • palpable peripheral pulses
  • skin pale, warm
  • mild tachycardia
No haemodynamic compromise, e.g.
  • palpable peripheral pulses
  • skin pale, warm
No haemodynamic compromise, e.g.
  • palpable peripheral pulses
  • skin pale, warm
Circulation
s/s dehydration *
Uncontrolled haemorrhage > s/s dehydration 3-6 s/s dehydration <3 s/s dehydration No s/s dehydration

* Signs/symptoms dehydration:
↓ LOC/activity, cap refill >2 sec, dry oral mucosa, sunken eyes.
↓ tissue turgor, absent tears, deep respirations, thready/weak pulse/tachycardia.
↓ urine output.

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PPD Category 1
Immediate
Category 2
Emergency
Within 10 minutes
Category 3
Urgent
within 30 minutes
Category 4
Semi-urgent
Within 60 minutes
Category 5
Non-urgent
Within 120 minutes
Disability GCS <8 GCS 9-12
Severe decrease in activity, e.g.
  • no eye contact
  • decreased musle tone
Severe pain, e.g.
  • patient/parents report severe pain
  • skin pale, cool
  • alteration in vital signs
  • requests analgesia
Severe neurovascular compormise, e.g.
  • pulseless
  • cold
  • nil sensation
  • nil movement
  • ↓ capillary refill
GCS >13
Moderate decrease in activity, e.g.
  • lethargy
  • eye contact wihen disturbed
Moderate pain, e.g.
  • patient/parents report moderate pain
  • skin pale, warm
  • alteration in vital signs
  • requests analgesia
Moderate neurovascular compormise, e.g.
  • pulse present
  • cool
  • sensation
  • movement
  • ↓ capillary refill
Normal GCS or no acute change to usual GCS
Mild decrease in activity, e.g.
  • quiet but eye contact
  • interacts with parents
Mild pain, e.g.
  • patient/parents report mild pain
  • skin pink, warm
  • no alteration in vital signs
  • requests analgesia
Mild neurovascular compormise, e.g.
  • pulse present
  • normal/↓ sensation
  • normal/↓ movement
  • normal capillary refill
Normal GCS or no acute change to usual GCS
No alteration in activity, e.g.
  • playing
  • smiling
No or mild pain, e.g.
  • patient/parents report mild pain
  • skin pink, warm
  • no alteration in vital signs
  • declines analgesia
No neurovascular compormise

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