Emerg Med J 26:484-486 doi:10.1136/emj.2008.065508
  • Original Article

The Manchester Triage System provides good reliability in an Australian emergency department

  1. A I Grouse,
  2. R O Bishop,
  3. A M Bannon
  1. Department of Emergency Medicine, Nepean Hospital, Penrith, NSW, Australia
  1. Dr A I Grouse, Department of Emergency Medicine, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Australia; grousea{at}
  • Accepted 28 October 2008


Background: The Australasian Triage Scale is a simple five-point system of triage that forms the basis of triage in most emergency departments in Australia. The Manchester Triage System (MTS) is an algorithmic aid to the process of triage. It utilises a series of flow charts that lead the triage nurse to a logical choice of triage category also using a five-point scale.

Objective: To evaluate the inter-rater reliability of the MTS in an Australian emergency department.

Methods: 50 triage scenarios were derived from the notes of 50 consecutive patients who had presented to the emergency department. All available nurses who had been trained to use the MTS were invited to participate in the study. The nurses were asked to assign a triage category to each scenario using the MTS. Weighted kappas were calculated for all pairs of raters.

Results: 20 nurses participated in the study. The range of kappas was 0.4007 to 0.8018, with a median of 0.6304.

Conclusion: The MTS is a reliable system of triage in the emergency department.


  • Funding: This study was funded entirely by the emergency department’s operating budget. No additional funds were received.

  • Competing interests: None.

  • Ethics approval: The study was approved by the local ethics committee.