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

Not Applicable

Recruiting

• Conditions: Triage; Emergency Department Triage; Emergency Department Overcrowding; Emergency Medicine

• Registration Number: NCT07123857
• Lead Sponsor: University Medical Centre Maribor

Brief Summary

Although the Manchester Triage System (MTS) is widely used and validated internationally, it has some limitations. Its accuracy is moderate, especially for children and the elderly. Rising patient numbers and overcrowded emergency departments increase wait times, sometimes beyond safe limits. In Slovenia, MTS has been in use for 14 years without major updates, despite a significant rise in emergency visits. The yellow triage category (60-minute wait time) includes a very diverse group of patients, some of whom might require faster care. Older patients, in particular, often show atypical symptoms and may be under-triaged. Including rapid bedside lab tests, like blood lactate levels, could improve risk assessment and triage accuracy. Elevated lactate is linked with higher mortality and can help identify critically ill patients more effectively. The proposed study is a prospective, randomized trial involving two groups of patients in the yellow triage category, all of whom will have their capillary blood lactate levels measured. Patients with normal lactate levels will be excluded. Only patients with elevated lactate will be compared. The test group will be re-triaged to the orange category and treated more urgently. The control group, despite also having high lactate levels, will remain in the yellow category, and their elevated lactate values will not be shared with the treating physician. Randomization will be based on the patient's birth date (even days = test group, odd days = control group). Only the nurse will know the result, maintaining physician blinding to avoid the Hawthorne effect-changes in behavior due to awareness of being studied. Standard lab tests will be performed later during treatment as deemed necessary by the attending doctor.

Detailed Description

Not available

Study Timeline

• Study Start: 2025-07-10
• Study First Submitted: 2025-07-16
• Status Verified: 2025-08
• Study First Submitted QC: 2025-08-07
• Last Update Submitted: 2025-08-07
• Study First Posted: 2025-08-14
• Last Update Posted: 2025-08-14
• Primary Completion: 2026-12-31
• Study Completion: 2026-12-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

• signed consent, yellow MTS triage category

Exclusion Criteria

• pregnant women, trauma patients, epileptic seizures, adrenergic therapy in prehospital unit

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Vasoactive drug use	30-day

Secondary Outcome Measures

Name	Time	Method
In-hospital mortality	30-day
ICU admission	30-day

Trial Locations

Locations (1)

University Medical Center Maribor; 🇸🇮 Maribor, Slovenia