Detecting high-risk patients with chest pain.

AIM

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.

METHOD

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.

CONCLUSION

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.