Safety recommendation
It is recommended that the Manchester Triage International Reference Group considers the addition of ‘aortic pain’ to the Manchester Triage System as a discriminator for chest pain, to raise awareness of acute aortic dissection as a potential cause.
Response:
As recommended, we considered the addition of ‘aortic pain’ as a discriminator in the Manchester Triage System (MTS). We have added this not only to the chest pain chart but also to the charts for back pain, abdominal pain and collapse.
The definition is: ‘The onset of symptoms is sudden and the leading symptom is severe abdominal or chest pain.
The pain may be described as sharp, stabbing or ripping in character. Classically aortic chest pain is felt around the sternum and then radiates to the shoulder blades, aortic abdominal pain is felt in the centre of the abdomen and radiates to the back.
The pain may get better or even vanish and then recur elsewhere. Over time, pain may also be felt in the arms, neck, lower jaw, stomach or hips.’
The update has been launched worldwide for use by all countries who have implemented (MTS) for face-to-face and telephone triage.
It has been made available in an update document on our website: www.triagenet.net. It will also be updated at next reprint in our published text books.
Response received on 17 April 2020.