Detecting high-risk patients with chest pain

Emerg Nurse. 2003 Sep;11(5):19-21. doi: 10.7748/en2003.


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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Angina Pectoris / diagnosis*
  • Chest Pain / classification*
  • Chest Pain / diagnosis
  • Chest Pain / nursing*
  • Cohort Studies
  • Diagnosis, Differential
  • Electrocardiography / nursing*
  • Emergency Nursing / methods*
  • False Negative Reactions
  • Humans
  • Prospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Triage / methods*