MEWS
Modified Early Warning Score
További információk
Figyelmeztetés
Ez az eszköz kizárólag oktatási célra szolgál, és nem jelent vagy helyettesít szakmai tanácsot. Az eszköz nem használható orvosi diagnózis felállítására és/vagy orvosi kezelés nyújtására.
General description
Documented deterioration of physiological parameters frequently precedes catastrophic deterioration of hospitalized patients. The modified Early Warning Score (MEWS) is a screening tool that can be used to identify patients who are at increased risk.
MEWS is based on four standard physiological parameters that can be monitored at patients’ bedside (systolic blood pressure, pulse rate, respiratory rate, temperature) and on a simple consciousness-level scale (AVPU).
The resulting score stratifies patients into 3 groups with different probabilities of catastrophic deterioration (in this case defined as high-dependency / intensive care unit admission or death within 60 days).
There are several different versions of MEWS. The implemented version (Subbe et al.) has been prospectively and externally validated. Another version (Stenhouse et al.) that includes urine output and a different blood pressure scale, was developed primarily for surgical patients.
Documented deterioration of physiological parameters frequently precedes catastrophic deterioration of hospitalized patients. The modified Early Warning Score (MEWS) is a screening tool that can be used to identify patients who are at increased risk.
MEWS is based on four standard physiological parameters that can be monitored at patients’ bedside (systolic blood pressure, pulse rate, respiratory rate, temperature) and on a simple consciousness-level scale (AVPU).
The resulting score stratifies patients into 3 groups with different probabilities of catastrophic deterioration (in this case defined as high-dependency / intensive care unit admission or death within 60 days).
There are several different versions of MEWS. The implemented version (Subbe et al.) has been prospectively and externally validated. Another version (Stenhouse et al.) that includes urine output and a different blood pressure scale, was developed primarily for surgical patients.
Result ranges
7.9 % probability of HDU/ICU admission or death within 60 days
0–212.7 % probability of HDU/ICU admission or death within 60 days
3–430 % probability of HDU/ICU admission or death within 60 days
Critical score - increased risk of catastrophic deterioration
5–9Critical score - increased risk of catastrophic deterioration
Critical score - increased risk of catastrophic deterioration
Probability of deterioration was not calculated for the group of patients with > 9 points in the original study
10–14Probability of deterioration was not calculated for the group of patients with > 9 points in the original study
HDU: high dependency unit; ICU: intensive care unit
Formula
The score is a sum of points obtained by answering the questions.
Systolic blood pressure [mmHg]:
< 70 (3 points), 71–80 (2 points), 81–100 (1 point), 101–199 (0 points), ≥ 200 (2 points)
< 70 (3 points), 71–80 (2 points), 81–100 (1 point), 101–199 (0 points), ≥ 200 (2 points)
Heart rate [bpm]:
< 40 (2 points), 41–50 (1 point), 51–100 (0 points), 101–110 (1 point), 111–129 (2 points), ≥ 130 (3 points)
< 40 (2 points), 41–50 (1 point), 51–100 (0 points), 101–110 (1 point), 111–129 (2 points), ≥ 130 (3 points)
Respiratory rate [bpm]:
< 9 (2 points), 9–14 (0 points), 15–20 (1 point), 21–29 (2 points), ≥ 30 (3 points)
< 9 (2 points), 9–14 (0 points), 15–20 (1 point), 21–29 (2 points), ≥ 30 (3 points)
Temperature [°C]:
< 35 (2 points), 35–38.4 (0 points), ≥ 38.5 (2 points)
< 35 (2 points), 35–38.4 (0 points), ≥ 38.5 (2 points)
AVPU score:
Alert (0 points), Reacting to voice (1 point), Reacting to pain (2 points), Unresponsive (3 points)
Alert (0 points), Reacting to voice (1 point), Reacting to pain (2 points), Unresponsive (3 points)
References
Subbe, C P et al. “Validation of a modified Early Warning Score in medical admissions.” QJM: monthly journal of the Association of Physicians vol. 94,10 (2001): 521-6. doi:10.1093/qjmed/94.10.521
Verzió
1
Az eszközről
Documented deterioration of physiological parameters frequently precedes catastrophic deterioration of hospitalized patients. The modified Early Warning Score (MEWS) is a screening tool that can be used to identify patients who are at increased risk.
MEWS is based on four standard physiological parameters that can be monitored at patients’ bedside (systolic blood pressure, pulse rate, respiratory rate, temperature) and on a simple consciousness-level scale (AVPU).
The resulting score stratifies patients into 3 groups with different probabilities of catastrophic deterioration (in this case defined as high-dependency / intensive care unit admission or death within 60 days).
There are several different versions of MEWS. The implemented version (Subbe et al.) has been prospectively and externally validated. Another version (Stenhouse et al.) that includes urine output and a different blood pressure scale, was developed primarily for surgical patients.
MEWS is based on four standard physiological parameters that can be monitored at patients’ bedside (systolic blood pressure, pulse rate, respiratory rate, temperature) and on a simple consciousness-level scale (AVPU).
The resulting score stratifies patients into 3 groups with different probabilities of catastrophic deterioration (in this case defined as high-dependency / intensive care unit admission or death within 60 days).
There are several different versions of MEWS. The implemented version (Subbe et al.) has been prospectively and externally validated. Another version (Stenhouse et al.) that includes urine output and a different blood pressure scale, was developed primarily for surgical patients.
