The Manchester triage system: improvements for paediatric emergency care. Issue 8 (14th February 2012)

• Record Type: Journal Article
• Authors: van Veen, Mirjam; Steyerberg, Ewout W; van't Klooster, Mariët; Ruige, Madelon; van Meurs, Alfred H J; van der Lei, Johan; Moll, Henriëtte A
• Is Part Of: Emergency medicine journal. Volume 29:Issue 8(2012)
• Page Start: 654
• Page End: 659
• Publication Date: 2012-02-14
• Subjects: Triage -- epidemiology -- emergency medical services -- child -- emergency department -- paediatrics -- paediatric emergency medicine; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emermed-2011-200562
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Objective: To improve the Manchester Triage System (MTS) in paediatric emergency care. Methods: The authors performed a prospective observational study at the emergency departments of a university and teaching hospital in The Netherlands and included children attending in 2007 and 2008. The authors developed and implemented specific age-dependent modifications for the MTS, based on patient groups where the system's performance was low. Nurses applied the modified system in 11 481 (84%) patients. The reference standard for urgency defined five levels based on a combination of vital signs at presentation, potentially life-threatening conditions, diagnostic resources, therapeutic interventions and follow-up. The reference standard for urgency was previously defined and available in 11 260/11 481 (96%) patients. Results: Compared with the original MTS specificity improved from 79% (95% CI 79% to 80%) to 87% (95% CI 86% to 87%) while sensitivity remained similar ((63%, 95% CI 59% to 66%) vs (64%, 95% CI 60% to 68%)). The diagnostic OR increased (4.1 vs 11). Conclusions: Modifications of the MTS for paediatric emergency care resulted in an improved specificity while sensitivity remained unchanged. Further research should focus on the improvement of sensitivity.