ArticleBMC emergency medicine2021
Validity and reliability of the South African Triage Scale in prehospital providers.
Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Manchester Triage System: Effectiveness, Limitations, and Global Implementation-A Structured Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- An inter-rater reliability study of a modified version of SATS as a prehospital triage tool.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Identifying barriers and facilitators to implementing triage systems in low- and middle-income countries: A scoping review.PLOS global public health · 2026Article
- Vehicle extrication in road traffic crashes: a descriptive analysis of an advanced medical rescue service in South Africa.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- The prehospital paediatric emergency care burden managed by a public ambulance service in the Western Cape, South Africa.BMC emergency medicine · 2024Article
- Feasibility of conducting a military-relevant multicenter cohort study to assess outcomes of early trauma resuscitative interventions in a prolonged care civilian setting.The journal of trauma and acute care surgery · 2023Article
- Changes in trauma-related emergency medical services during the COVID-19 lockdown in the Western Cape, South Africa.BMC emergency medicine · 2023Article
- Reliability and validity of Chengdu pediatric emergency triage criteria: case study of a single center in China.BMC pediatrics · 2023Article
- Is the Triage System Welcomed in the Tertiary Hospital of the Limpopo Province? A Qualitative Study on Patient's Perceptions.Nursing reports (Pavia, Italy) · 2023Article
- Risks of Early Mortality and Associated Factors at Adult Emergency Department of Jimma University Medical Center.Open access emergency medicine : OAEM · 2023Article
- Comparison of the novel WEst coast System for Triage (WEST) with Rapid Emergency Triage and Treatment System (RETTS©): an observational pilot study.International journal of emergency medicine · 2022Article
- Implementation of the South African Triage Scale (SATS) in a New Ambulance System in Beira, Mozambique: A Retrospective Observational Study.International journal of environmental research and public health · 2022Observational
- Prehospital triage tools across the world: a scoping review of the published literature.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Using the South African Triage Scale for prehospital triage: a qualitative study.BMC emergency medicine · 2021Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe South African Triage Scale (SATS) is a validated in-hospital triage tool that has been innovatively adopted for use in the prehospital setting by Western Cape Government (WCG) Emergency Medical Services (EMS) in South Africa. The performance of SATS by EMS providers has not been formally assessed. The study sought to assess the validity and reliability of SATS when used by WCG EMS prehospital providers for single-patient triage.
methodsThis is a prospective, assessment-based validation study among WCG EMS providers from March to September 2017 in Cape Town, South Africa. Participants completed an assessment containing 50 clinical vignettes by calculating the three components - triage early warning score (TEWS), discriminators (pre-defined clinical conditions), and a final SATS triage color. Responses were scored against gold standard answers. Validity was assessed by calculating over- and under-triage rates compared to gold standard. Inter-rater reliability was assessed by calculating agreement among EMS providers' responses.
resultsA total of 102 EMS providers completed the assessment. The final SATS triage color was accurately determined in 56.5%, under-triaged in 29.5%, and over-triaged in 13.1% of vignette responses. TEWS was calculated correctly in 42.6% of vignettes, under-calculated in 45.0% and over-calculated in 10.9%. Discriminators were correctly identified in only 58.8% of vignettes. There was substantial inter-rater and gold standard agreement for both the TEWS component and final SATS color, but there was lower inter-rater agreement for clinical discriminators.
conclusionThis is the first assessment of SATS as used by EMS providers for prehospital triage. We found that SATS generally under-performed as a triage tool, mainly due to the clinical discriminators. We found good inter-rater reliability, but poor validity. The under-triage rate of 30% was higher than previous reports from the in-hospital setting. The over-triage rate of 13% was acceptable. Further clinically-based and qualitative studies are needed.
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