JOURNAL ARTICLE

The Manchester Triage System in acute coronary syndromes

Carla Matias, Ricardo Oliveira, Rita Duarte, Pedro Bico, Carlos Mendonça, Luís Nuno, António Almeida, Carlos Rabaçal, Sieuve Afonso
Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology 2008, 27 (2): 205-16
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INTRODUCTION: A growing number of hospitals have implemented the Manchester Triage System (MTS) in their Emergency Department (ED), so as to better prioritize the evaluation of those attending these departments.

OBJECTIVES: To assess whether the MTS was used effectively in patients admitted to the hospital with a diagnosis of acute coronary syndrome (ACS).

METHODS: We evaluated 114 consecutive patients admitted to the Cardiology Department with a diagnosis of ACS. We recorded the color assigned in the MTS, mean time from arrival in the ED to MTS, mean time from MTS to first medical assessment (1-MA) and mean time from 1-MA to admission. We also analyzed the correlation between the type of ACS and clinical presentation and its relation with MTS.

RESULTS: Of the 114 patients, one was coded red (0.9%), 71 orange (62.3%), 12 green (11%), and two were not assigned a color code according to MTS because they were admitted via a Medical Emergency and Resuscitation Vehicle. Mean time from arrival in the ED to MTS was 5.2 +/- 0.6 min and from MTS to MA was 20 +/- 2.5 min. In patients triaged as orange the time from MTS to MA was 15.1 +/- 1.5 min, as yellow 36.2 +/- 7 min, and as green 35.2 +/- 20.6 min (p = 0.003). Mean time from 1-MA to admission was 144.4 +/- 17 min, with no differences according to triage code or ACS type. Clinical presentation influenced triage and the speed of 1-MA and admission, patients with typical presentation being evaluated and admitted more quickly.

CONCLUSIONS: Most patients admitted for ACS are initially triaged as orange or yellow, an indication for prompt assessment in the ED; this has a positive effect on time to first medical assessment, but has no effect on time to hospital admission.

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