Detecting high-risk patients with chest pain.
OBJECTIVE
To assess the ability of nurses using the Manchester Triage System (MTS) to identify those patients with chest pain requiring immediate electrocardiogram (ECG) and physician assessment within ten minutes.


METHODS
A four-week prospective cohort of all patients attending with chest pain compared detection of risk by nurses using the MTS to that of researchers using best available evidence-based prognostic indicators from history.


RESULTS
The study of 167 patients showed that nurses using MTS had a sensitivity of 86.8 per cent (95 per cent confidence interval (CI), 78.4-92.3 per cent) and a specificity of 72.4 per cent (95 per cent CI, 61.4-81.2 per cent) when identifying high risk cardiac chest pain.


CONCLUSIONS
Nurses using the MTS are a sensitive tool for identifying high risk cardiac chest pain but further work is required to assess whether additional training can improve sensitivity.
Speake
Douglas
D
Manchester Royal Infirmary.
Teece
Stewart
S
Mackway-Jones
Kevin
K
D000787:Angina Pectoris / Q000175:diagnosis*; D002637:Chest Pain / Q000145:classification* / Q000175:diagnosis / Q000451:nursing*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000451:nursing*; D016529:Emergency Nursing / Q000379:methods*; D005188:False Negative Reactions; D006801:Humans; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014218:Triage / Q000379:methods*