Patient Pathway

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The National Emergency Medicine Programme (EMP) recommended that the Manchester Triage System (MTS) (Mackway-Jones et al, 2006) should be the triage system used for all new adult (16 years and over) patients presenting to Emergency Departments. This recommendation was further endorsed when the EMP was tasked by the Health Service Executive (HSE) to support implementation of the Report of the investigation into the quality, safety and governance of the care provided by the Adelaide and Meath Hospital, Dublin, incorporating the National Children’s Hospital (AMNCH) for patients who require acute admission, Health Information and Quality Authority, (HIQA Tallaght Report, 2012). This Report stated that “The Manchester Triage System must be implemented, managed and periodically evaluated to ensure it is being applied effectively in all hospitals”.

The EMP Emergency Nursing Interest Group (ENIG) was tasked with addressing these components of the programme and report with full support and guidance of the EMP Working Group. ENIG approved the engagement of the MTS Group for a national training strategy and agreed that the MTS Audit Tool should be used to audit triage practice.
Each Emergency Department (ED) is advised to refer to the EMP clinical guidance on “Audit of Emergency Department Triage”.


Since July 2014 all Emergency Departments in Ireland have a Manchester Triage Trainer. A complete list of trainers is available from emp@rcsi.ie

Emergency Department Monitoring and Escalation for Adult Patients

  • The Protocol is intended to assist Emergency Department (ED) clinical staff in establishing appropriate and effective monitoring and clinical escalation procedures for ED patients to protect and optimise the quality and safety of their care.
  • The Protocol has been designed to be applicable to the care of all ED patients from the moment of their arrival in an ED to their admission or discharge from the ED.
  • The parameters align with the National Early Warning Score.
  • Designed to meet the HIQA Tallaght (2012) requirement for a ‘system of physiological and triggered responses’ across all Emergency Departments (EDs).

Emergency Nursing Education

IAEM 2018