Study on Using Blood Lactate Testing to Improve Patient Prioritization in Emergency Departments with Manchester Triage System

What this Trial Is About

Researchers are studying the use of point-of-care blood lactate testing as an addition to the Manchester Triage System MTS in emergency departments. The MTS is widely used but has moderate accuracy, particularly for children and older adults, and often leads to long wait times. This study focuses on patients categorized as yellow in the MTS, who have a 60-minute expected wait time, but may include some who need faster care. Elevated blood lactate levels, linked to higher risk, are being examined to improve triage precision and patient management. The study is a prospective, randomized trial involving two groups of patients with elevated capillary blood lactate levels from the yellow MTS category. Patients with normal lactate levels are excluded. One group will be re-triaged to the orange MTS category for more urgent treatment, while the control group remains in the yellow category without their lactate results being shared with the treating physician. Randomization is based on birth date, and the nurses know the lactate results while physicians remain blinded. Additional standard lab tests may be done later as needed. Participants will be followed for 30 days to assess outcomes such as the use of vasoactive drugs, in-hospital mortality, and ICU admissions. The study involves careful monitoring and double blinding to reduce bias. The goal is to see if adding lactate testing improves triage decisions and patient care in overcrowded emergency settings. The trial is sponsored by the University Medical Centre Maribor and is expected to run through the end of 2026.

Impact of Point-of-care Lactate Testing as Triage Supplement on Patient Management Using Manchester Triage System