Modified early warning score 1

Modified early warning score

Modified early warning score (MEWS) is a simple guide used by emergency medical services to quickly determine
the risk of death of a subject. It is based on data derived from four physiological readings (systolic blood pressure,
heart rate, respiratory rate, body temperature) and one observation (level of consciousness, AVPU). The resulting
observations are compared to a normal range to generate a single score as follows:

Score 3 2 1 0 1 2 3

Systolic BP <70 71-80 81-100 101-199 — >200 —

Heart rate (BPM) — <40 41-50 51-100 101-110 111-129 >130

Respiratory rate (RPM) — <9 — 9-14 15-20 21-29 >30

Temperature (°C) — <35 — 35.0-38.4 — >38.5 —

AVPU — — — A V P U

A score of five or more is clearly linked to increased likelihood of death and admission to a intensive care unit.

Leeds Teaching Hospitals Trust (LTHT) Guidelines 2011

The MEWS may differ according to various Trusts. The Leeds Teaching Hospitals use a scoring system as shown
below (accurate as of February 2011)[1]

Score 3 2 1 0 1 2 3

Systolic BP <70 71-80 81-100 101-180 181-200 201-220 >220

Heart rate (BPM) <40 — 40-50 51-100 101-110 111-130 >130

Respiratory rate (RPM) <8 — 8-11 12-20 21-25 26-30 >30

Oxygen Saturations (%) <85 >85 >90 >94 — — —

Respiratory Support CPAP BiPAP >60% O2 Nil — — —

AVPU — — — Alert Voice Pain Unconscious

Urine Output (mls) <80 80-119 120-200 >200 >800 — —

Pain Score Severe Moderate Mild None — — —

References
• Subbe C.P., Kruger M., Gemmel L. - "Validation of a modified Early Warning Score in medical admissions."
Quarterly Journal of Medicine 2001; 94; 521-6.
[1] Brown, H. (2010). Graded Response Observation Chart (Leeds Teaching Hospitals Trust - Revision date: November 2012)

A problem with the MEWS system is that is has no score for diastolic blood pressure,ie when you heart is 'resting'
high diastolic rates are linked to heart disease stroke and death!
Article Sources and Contributors 2

Article Sources and Contributors

Modified early warning score  Source: http://en.wikipedia.org/w/index.php?oldid=414724331  Contributors: Bankhallbretherton, Iridescent, Redrose64, Russthomas1515, Sting au,
TwoOneTwo, 12 anonymous edits

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