Table 1

Modifications for the Manchester triage system (MTS) in paediatric emergency care

General discriminatorOriginal MTSModification
MTS flowchartMTS discriminatorUrgencyAge groupUrgencyCut-off level
Fever*General and urinary problemsHot childVery urgent0–2 mVery urgent80%
>3 mUrgent80%
Worried parent0–2 mVery urgent80%
3 m–3 yUrgent80%
4–15 yStandard80%
Sore throat, rashes and ear problems0–2 mVery urgent80%
3 m–15 yStandard80%
Time since onset of symptomsFalls, worried parent, sore throat, headache, rashes, eye problemsRecent problem§StandardNon-urgent45%
Persistent vomitingGeneral and vomiting and diarrhoeaPersistent vomitingUrgent0–2 mUrgent
3 m–15 yStandard75%
Specific discriminatorShortness of breath in childrenUnable to talk in sentencesVery urgentUrgent80%
WheezeStandardUrgent60% (higher urgency than Standard)
Head injuryScalp haematomaStandard<1 yStandard
>1 yNon-urgent65%
Worried parentNot feedingUrgent<1 yUrgent
>1 yStandard77%
Prolonged or uninterrupted cryingUrgent<1 yUrgent
>1 yStandard100%
RashesModerate pain/itchUrgentStandard90%
Rash that does not fade when pressed/petechiaeVery urgent
  • * Fever is defined as body temperature above 38.5°C.

  • m, months; y, years.

  • Proportion of patients who were allocated to a lower urgency level, according to the reference standard, as compared with the original MTS urgency level.

  • § Recent problem is defined as a problem arising in the last week.

  • New discriminator.