Table 5

35-Trigger Canadian Paediatric Trigger Tool

Care module
 C 01Transfusion/use of blood products
 C 02Any code or arrest (successfully resuscitated)
 C 03Unplanned admission (including readmission) as a result of any healthcare management within the 3 months prior to OR after discharge from the index hospitalisation
 C 04Infection of any kind
 C 05In hospital stroke
 C 06Transfer to higher level of care
 C 07Catheter infiltration/burn
 C 08Complication related to central venous catheter
 C 09Necrotising enterocolitis
 C 10Cranial imaging in infants ≤3 months
 C 11Extreme temperature: ≥35°C (35°C) or ≤40°C (40°C)
 C 12Intubation/reintubation/accidental extubation
 C 13Emergent C-section delivery (neonate only)
 C 14Dissatisfaction with care documented in the medical record and/or evidence of complaint lodged (including documented complaint, conflict between patient/family and staff, discharged against medical advice/documentation or correspondence indicating litigation, either contemplated or actual
 C 15Unexpected death
ICU module
 I 01Readmission to ICU
 I 02In-unit procedure
 I 03Failed extubation
Laboratory module
 L 01Abrupt drop ≥25% Hgb or Hct
 L 02Platelet count < 50 000/mm3 (50×10 e9 l)
 L 03PTT>100 s or INR>6
 L 04D-dimer (positive by local lab normal)
 L 05Sodium: 120 mmol/l>Na>150 mmol/l
 L 06Potassium: 3.0 mmol/l>K+>6.0 mmol/l
 L 07Rising BUN/creat >2×baseline
 L 08Hypoxia: O2 Sat <75%
 L 09Positive blood culture
 L 10Gentamicin/tobramycin: (except CF patients) trough <2 mg/l or peak >10 mg/l
Medication module
 M 01Vitamin K (excluding newborns)
 M 02Heparin or low-molecular-weight heparin
Surgical module
 S 01Unplanned or return to surgery
 S 02Intraoperative intravenous epinephrine, norepinephrine, naloxone, flumazenil
 S 03Removal/injury or repair of organ
 S 04Wrong site/wrong procedure/wrong patient
Other module
 O1Other/any other undesirable outcomes not covered above
  • ICU, intensive care unit; Hgb, haemoglobin; Hct, haematocrit; WBC, While blood count; PTT, partial thromboplastin time; INR, international normalised ratio; BUN, blood urea nitrogen; creat, creatinine; CF, cystic fibrosis; CV, cardiovascular.