Manchester Rule: Designed for rapid ED triage. Validated for high sensitivity (97%) in identifying risk of repetition or suicide within 6 months.
Emergency Risk Triage
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Assessment of patients presenting to the Emergency Department following self-harm
Screening for the risk of suicide or repeated self-harm within the following 6 months
Aiding the decision to discharge from the ED vs. psychiatric referral
Identifying "low-risk" patients with high sensitivity (97%)
Section 2
Formula & Logic
The 4 Essential Items
History of previous self-harm
History of any psychiatric treatment
Currently receiving psychiatric treatment
Index episode involved a method other than (or in addition to) self-poisoning
Scoring & Risk
If the patient answers NO to ALL four items, they are classified as LOW RISK. If any item is YES, the patient is classified as HIGH RISK for repetition or death.
Section 3
Evidence Appraisal
Validation
A medical chart review of self-harm patients: the Manchester Self-Harm Rule.
Cooper J et al. • Emerg Med J.. 2006;23(3):203-7. Showed that the rule has a sensitivity of 97% for identifying patients at risk of repetition or death within 6 months.
