Rethinking triage: enhancing the Manchester Triage System for headache emergencies

Abstract

I n the busy and often overcrowded emergency services environment, the Manchester Triage System (MTS) plays a crucial role in saving lives and optimizing care. Initially developed at the Manchester Royal Infirmary in 1997, this innovative system enhances care in emergency departments by ensuring that patients needing immediate attention receive the required priority (1, 2). Since its implementation, the Manchester Triage System has improved workflows and patient safety and set a global standard, being adopted as a standard protocol in numerous hospitals across the UK and beyond (1). Despite its widespread adoption and initial success, recent evaluations and studies suggest that the system might be failing to manage certain critical cases (3, 4), particularly those involving severe headaches such as migraines and cluster headaches. These conditions, often debilitating and intensely painful, require prompt and effective treatment, yet under the current triage protocol, they may not be prioritized appropriately.