The core Manchester Triage System reference, fully revised and updated

Emergency Triage, now in its Fourth Edition, is the core text for the Manchester Triage System, the most widely used triage system in the world. Written by members of the Manchester Triage Group, this edition delivers the latest protocols and updated prioritisation strategies for clinicians using face-to-face triage working in urgent and emergency care.

The fourth edition of Emergency Triage offers detailed advice on how to successfully implement and maintain the Manchester Triage System (MTS). This text often reads like a manual rather than a reference book with the inclusion of case studies to enhance understanding, clearly setting out the “how to use MTS in practice”.

This edition introduces a strict hierarchy of discriminators, reordering general and specific discriminators throughout priority levels. Revised flowcharts include updated mental health charts and the separation of the diarrhoea and vomiting chart into two charts, adults and children. New paediatric vital signs derived from a European multicentre study improve child prioritisation. Background chapters now document the origin of MTS, and practical examples support clinical decision-making.

• Readers will also find:
• A clear overview of how MTS works with logical sequencing that builds the process of clinical decision-making step by step
• Updated flowcharts aligned with current prioritisation strategies applicable across urgent and emergency care settings
• Evidence-based paediatric vital sign parameters from a European multicentre study designed to strengthen the prioritisation of children
• Historical context establishing the prequel to MTS and setting the record straight regarding the system's origins and development

Emergency Triage serves all health care providers involved in urgent and emergency care, including triage practitioners, emergency department staff, prehospital clinicians, and primary care clinicians. It functions both as a training tool for those learning the Manchester Triage System and as a daily clinical reference.

Jill Windle is a Triage Consultant Nurse with the Advanced Life Support Group and a retired Lecturer Practitioner in Emergency Nursing at Salford Royal Hospitals NHS Foundation Trust and the University of Salford, combining frontline triage expertise with years of clinical teaching experience.

Kevin Mackway-Jones is a retired Consultant Emergency Physician from Manchester Royal Infirmary and Manchester Children's Hospital, and Medical Director of the North West Ambulance Service, bringing decades of emergency medicine leadership to the development of the Manchester Triage System.

Stephanie Allmark is a Paramedic with the North West Ambulance Service and an Emergency Department nurse who leads Clinical Development for the Manchester Triage Group, contributing both prehospital and hospital-based clinical triage perspectives to this edition.

Janet Marsden is the late Professor of Ophthalmology and Emergency Care and former Director of the Centre for Effective Emergency Care at Manchester Metropolitan University, whose sustained research contributions advanced evidence-based emergency care practice and shaped clinical education across the discipline.