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Detecting high-risk patients with chest pain
Douglas Speake1, Stewart Teece, Kevin Mackway-Jones
1Manchester Royal Infirmary.
Summary
Nurses using the Manchester Triage System (MTS) effectively identify high-risk cardiac chest pain patients needing urgent care. Further training may enhance the sensitivity of this crucial emergency department tool.
Area of Science:
- Emergency Medicine
- Nursing Triage Systems
- Cardiology
Background:
- Timely identification of high-risk cardiac chest pain is critical in emergency departments.
- The Manchester Triage System (MTS) is widely used by nurses for patient assessment.
- Assessing the accuracy of MTS in identifying patients requiring immediate electrocardiogram (ECG) and physician evaluation is essential.
Purpose of the Study:
- To evaluate the effectiveness of nurses utilizing the Manchester Triage System (MTS) in identifying patients with chest pain who require immediate ECG and physician assessment.
- To determine the sensitivity and specificity of the MTS for detecting high-risk cardiac chest pain.
Main Methods:
- A prospective cohort study was conducted over four weeks.
- All patients presenting with chest pain were included.
- Nurse-led MTS assessments were compared against researcher-led evaluations using evidence-based prognostic indicators.
Main Results:
- The study included 167 patients with chest pain.
- Nurses using MTS achieved a sensitivity of 86.8% (95% CI, 78.4-92.3%) for identifying high-risk cardiac chest pain.
- The specificity for identifying high-risk cardiac chest pain was 72.4% (95% CI, 61.4-81.2%).
Conclusions:
- The Manchester Triage System (MTS) demonstrates good sensitivity in identifying patients with high-risk cardiac chest pain.
- While sensitive, further research is needed to explore if additional nurse training can improve MTS accuracy.
- MTS serves as a valuable tool for prioritizing chest pain patients in emergency settings.