In-hospital triage of ischemic stroke admissions using the Manchester triage system [Triagem intrahospitalar das admissões por acidente vascular cerebral isquémico através do sistema de triagem de prioridades de Manchester]

• Type: Article in International Scientific Journal
• Date: 2007

Authors

Gabriel, JP (Author) Other; Velon, A (Author) Other; Valerio, C (Author) Other; Marcos, A (Author) Other; Pimenta, F (Author) Other; Vaz, S (Author) Other; Sousa, J (Author) Other; Fructuoso, M (Author) Other; Azevedo L (Author) FMUP; Afonso, F (Author) Other; Ribeiro, P (Author) Other; Silva, MR (Author) Other

Journal

Title: Sinapse

Vol. 7 No. 1

Pages: 28-35

ISSN: 1645-281X

Publisher: Sociedade Portuguesa de Neurologia

Indexing

Scopus - 2 Citations

Other information

Authenticus ID: P-007-HTB

Abstract (EN): Background: Emergency department triage systems are crucial to shorten the time interval between the onset of symptoms and the treatment of ischemic stroke (IS) victims. In our hospital, as well in all others in Portugal were stroke units exist, triage of patients upon arrival to the emergency department (ED) is performed using the Manchester Triage System (MTS). Purpose: To evaluate triage categories attributed by the MTS to IS patients admitted to our stroke unit, regarding the timeframe internationally recommended for ED evaluation of acute stroke patients. Methods: Retrospective evaluation of MTS triage categories and flowchart codes, type of IS (using the Oxfordshire Community Project classification), mRS and NIH-SS scores at admission, of all consecutive admissions in our stroke unit between the 1st January and the 30 th June 2006. Results: 163 admissions were included, corresponding to 158 patients [75 females, mean age at admission - 74,5 years (minimum 41, maximum 97, SD 10,398)]. Types of IS identified: 54 total anterior circulation infarctions (33%), 48 partial anterior circulation infarctions (29%), 30 lacunars infarctions (18%) and 31 posterior circulation infarctions (19%); median of mRS and NIH-SS scores at admission, were respectively 4,0 and 8,5. MTS flowcharts identified: Behaving strangely n=76 (48%), unwell adult n= 47 (29%), headache n=15 (9%), falls n=4 (2,5%), vomiting, altered conscious level and dyspnoea, n=3 (2%) each one, eye problems n=2 (1,3%), fits, limb problems, neck pain and diabetes, n=1 (0,6%) each one. Triage categories attributed: no. 1: Immediate [red, to be seen (TBS) immediately]: n=3 (1,9%); no. 2: very urgent (orange, TBS in 10 minutes): n=26 (16,3%); no. 3: urgent (yellow, TBS in 60 minutes): n=102 (63,8%); no. 4: standard (green, TBS in 120 minutes) n=26 (16,3%), no. 5: non-urgent (blue, TBS in 240 minutes) (n=0), other cases (white) n=3 (1,9%); and no information available: n=3 (1,9%). Conclusions: By using MTS, we found that only 18,1% of our cases achieved the opportunity to comply with the timeframe of 10 minutes, international recommended for initial clinical evaluation of stroke patients, which we considered insufficient. Our data underline the merit of the recent MTS protocol modifications carried out regarding acute stroke patient's triage, and argue for a promptly implementation of this new version of the protocol in our national ED network.

Language: Portuguese

Type (Professor's evaluation): Scientific