APPLICATION OF THE MANCHESTER PROTOCOL IN THE RISK CLASSIFICATION OF THE ELDERLY: CHALLENGES AND EFFICACY IN THE EMERGENCY SERVICE

Abstract

Population aging has led to a progressive increase in demand for emergency and urgent care services, making it necessary to adopt strategies capable of organizing care and identifying, safely and promptly, patients with greater clinical severity (WORLD HEALTH ORGANIZATION, 2021). In this context, the Manchester Triage System (MTS) is a tool used for risk classification according to clinical criteria and levels of priority. However, the application of the protocol to the older population presents challenges related to the characteristics of aging, including multimorbidity, frailty, functional and cognitive changes, and atypical clinical manifestations. The objective of this review was to analyze the scientific evidence regarding the application of the Manchester Triage System in the risk classification of older adults in urgent and emergency care services, identifying its benefits, limitations, and challenges for the quality and safety of care. This is an integrative literature review, developed through a search for scientific studies in the databases defined by the authors, using descriptors related to the Manchester Triage System, risk classification, older adults, and urgent and emergency care services. National and international studies addressing the use of the protocol or aspects directly related to risk classification in the older population were considered. The analyzed literature indicates that the Manchester Triage System contributes to organizing the care flow and prioritizing patients according to clinical severity, but it has limitations when applied in isolation to the older population. Evidence indicates that the predictive capacity of the system may differ in older patients, particularly regarding certain outcomes, reinforcing the importance of clinical judgment and reassessment. In addition, comprehensive assessment strategies, effective communication, teamwork, and humanization are important for improving care. It is concluded that the MTS is an important tool for organizing urgent and emergency care services, but its use in older adults should be associated with qualified clinical assessment, professional training, and consideration of the specific characteristics of aging.