Triage in clinical acute and emergency medicine-background knowledge for daily practice

Triage in emergency medicine ensures that patients are treated according to their medical urgency. In Germany, triage has become an indispensable tool, especially since the decree of the G-BA (Federal Committee on Healthcare) in 2020. The Manchester Triage System (MTS) and the Emergency Severity Index (ESI) are predominantly used-both are validated but have weaknesses in triage accuracy. There is generally little awareness of this, just like the subjective elements of triage, which can lead to misjudgements, particularly in older patients or in overcrowded emergency departments. Furthermore, the validation of initial assessment systems is a challenge as there are no agreed reference standards. The process is not finished once an initial assessment system has been chosen; regular training, adherence monitoring and audits are necessary and require personnel and time resources. In the future, the use of artificial intelligence (AI)-based systems could facilitate triage for nurses and improve quality. Nevertheless, the experience and training of nursing staff are essential.