North Carolina — Targeted Issue
Evaluation of the Emergency Severity Index for Pediatric Triage
March 1, 2005 - Feb. 29, 2008


University of North Carolina at Chapel Hill
Principal Investigator(s)
Award Amount


HRSA Region


EMSC Region


HPP Region





Name Roles Agency Mailing Address Office Phone Email
Anna Waller, ScD
  • Principal Investigator
University of North Carolina at Chapel Hill


Title Published Description Format Availability
Annotated Bibliography-Pediatric Triage Literature 2006 PDF document Available Online
Set of 25 Pediatric Case Studies: Emergency Department Triage 2010 PDF document Available Online
ESI for Pediatric Triage Webcast 2010 Webcast/webinar Available Online
Emergency Severity Index (ESI), A Triage Tool for Emergency Department Care. Version 4 Implementation Handbook, 2012 2012 This handbook covers all details of the Emergency Severity Indexa five level emergency department (ED) triage algorithm that provides clinically relevant stratification of patients into five groups from least to most urgent based on acuity and, unique to ESI, resource needs. This edition ntroduces a new section (Chapter 6), developed in response to numerous requests for more detailed information on using the ESI algorithm with pediatric populations. The section recognizes that the needs of children in the emergency room differ from the needs of adults, including:

Different physiological and psychological responses to stressors.
More susceptibility to a range of conditions, such as viruses, dehydration, or radiation sickness.
Limited ability to communicate with care providers; thus harder to quickly and accurately assess.

In keeping with our mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans, one of AHRQ's areas of emphasis is improved training for the health care workforce. This handbook will provide invaluable assistance to ED nurses, physicians, and administrators in the
implementation of a comprehensive ESI educational program. In turn, a well-implemented ESI program will help hospital emergency departments rapidly identify patients in need of immediate attention, and better identify patients who could safely and more efficiently be seen in a fast-track or urgent-care area rather than in the main ED.
E-publication Available Online


Title Published Author Abstract Publication PMID
Reliability and validity of the emergency severity index for pediatric triage. 2009 Travers, D., Waller A., Katznelson J., & Agans R Academic Emergency Medicine, 16(9), 843-849 19845551
Creation of a Validated Set of Pediatric Case Scenarios for the Emergency Severity Index Triage System 2006 Katznelson J, Hohenhaus S, Travers D, Agans R, Trocinski D, Waller A Acad Emerg Med 0
Is the ESI reliable for pediatric triage? 2006 Rosenau A, for the Pediatric ESI Research Consortium (A Waller, D Trocinski, D Travers, V Rupp, A Rosenau, N Mecham, J Katznelson, S Hohenhaus, T Eubanks, D Eitel, R Agans) Annals of Emergency Medicine 0
Reliability of the Emergency Severity Index Version 4 2006 Travers D, Agans R, Eitel D, Mecham N, Rosenau A, Tanabe P, Trocinski D, Waller A Acad Emerg Med 0