“Nurse triage in acute coronary syndrome: Are we prioritizing those who need it most?"

Introduction:
Acute myocardial infarction is one of the leading causes of morbidity and mortality worldwide, representing a time-dependent emergency that requires prompt and prioritized care. In this context, nurse triage plays a crucial role by classifying patients early according to their clinical severity. Accurate priority assignment helps reduce critical care delays and optimizes management, particularly in high-incidence cardiovascular conditions such as acute coronary syndrome.

Objective:
This study aimed to describe the distribution of triage priority according to principal diagnosis, age, sex, and mode of arrival to the hospital in patients treated in the emergency department and analyze its potential association with these variables.

Methodology:
A descriptive, observational, and retrospective study was conducted in the emergency department of Hospital Universitario de La Ribera between January 1 and December 31, 2024. Adult patients triaged using the Manchester Triage System were included. Sociodemographic, clinical, and operational variables were analyzed. The study was approved by the Ethics Committee.

Results:
A total of 554 patients were included, with a mean age of 67.09 years (SD: 15.85); 70.9% (393) were male. The most frequent triage level was P3 39.0% (216), followed by P2 28.9% (160). The most common diagnoses were angina pectoris 32.3% (179), ST-elevation myocardial infarction 30.5% (169), and non-ST-elevation myocardial infarction 29.1% (161). The most frequently used triage diagram was chest pain 68.8% (381), followed by adult with general malaise 14.3% (79). Of all patients, 54.3% (301) arrived by ambulance—most classified as P1–P2—while 45.7% (253) arrived by their own means, mainly classified as P3–P4 (p < 0.001). Significant differences in care times were also observed based on triage level (p < 0.05).

Conclusion:
This study reinforces the essential role of nursing in initial clinical decision-making, demonstrating consistent priority assignment aligned with clinical severity and resource mobilization. Ongoing evaluation and improvement of nurse triage are key to ensuring patient safety and emergency care efficiency.