Validity of the Manchester Triage System in the Prioritization of Patients with Transient Global Amnesia in the Emergency Department

Background The Manchester Triage System (MTS) is one of the most widely used and studied triage systems in emergency departments (ED). MTS does not have a specific presentational flow chart for patients with transient global amnesia (TGA). The goal of this study was to determine the adequacy of priority code assignment for patients with TGA presenting at the ED and triaged using the MTS.Methods This is a single-center observational retrospective study from January 01, 2013 to June 31, 2020. All patients with a medical diagnosis of TGA were considered. An audit was conducted on these triages to assess the correct application of MTS by the triage nurses. Correct triage was considered as a patient classified as yellow.Results During the study period, 216 patients with a diagnosis of TGA were considered. Of these 49.5% were classified as yellow, 13.0% were undertriage and classified as green or blue and 37.5% were overtriaged and classified as orange or red. The audit demonstrated that 98.8% of overtriaged patients and 57.1% of undertriage patients were triaged incorrectly. In addition, in 38 patients the triage nurse confused TGA with an acute neurological deficit suggestive of stroke or transient ischemic attack.Conclusion The present study demonstrates an inability of MTS to correctly stratify patients with TGA. The results of the present study indicate the need for a specific flow chart for patients with neurological problems to improve the performance of MTS.