Intended for healthcare professionals


Manchester triage system in paediatric emergency care

BMJ 2008; 337 doi: (Published 22 September 2008) Cite this as: BMJ 2008;337:a1507
  1. Ian Maconochie, consultant in paediatric emergency medicine1,
  2. Mary Dawood, nurse consultant in emergency medicine2
  1. 1Department of Paediatric Emergency Medicine, Imperial College Healthcare NHS Trust, St Mary’s Campus, London W2 1NY
  2. 2Department of Emergency Medicine, Imperial Healthcare NHS Trust
  1. i.maconochie{at}

    Has moderate validity, but could be improved by incorporating physiological parameters

    The Manchester triage system is used in emergency departments to determine the clinical priority of patients on the basis of their presenting features.1 It is not a diagnostic based system but ascribes a time by which ideally each patient should be seen by a clinician. It therefore functions as a risk management tool and can also be used to monitor overall activity in the emergency department. It is widely used in the United Kingdom and Europe. In the linked study (doi:10.1136/bmj.a1501), Van Veen and colleagues assess the validity of this system in 17 600 children visiting an emergency department in the Netherlands in 2006-7.2

    Using this system, experienced clinicians, such as emergency department nurses, assess patients on the basis of the available history and, by means of focused questioning, choose one of 52 flow pathways. The sequential questions delineate the risk and hence the time in which the patient …

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