Accutorr 7 Operator’s Manual 12 - 1
12 Clinical Scoring
12.1 Overview
The Early Warning Score (EWS) is a simple physiological scoring system suitable for
bedside application. The ability of a modified Early Warning Score (EWS) to identify
medical patients at risk of catastrophic deterioration in a busy clinical area was
investigated. In a prospective cohort study, we applied MEWS to patients admitted to
the 56-bed acute Medical Admissions Unit (MAU) of a District General Hosipital (DGH).
Data on 709 medical emergency admissions were collected during March 2000. Main
outcome measures were death, intensive care unit (ICU) admission, high dependency
unit (HDU) admission, cardiac arrest, survival and hospical discharge at 60 days. Scores of
5 or more were associated with increased risk of death (OR 5.4, 95% CI 2.8-10.7), ICU
admission (OR 10.9, 95% CI 2.2-55.6), and HDU admission (OR 3.3, 95% CI 1.2-9.2). MEWS
can be applied easily in a DGH medical admission unit, and identifies patients at risk of
deterioration who require increased levels of care in the HDU or ICU. A clinical pathway
could be created, using nurse practitioners and/or critical care physicians, to respond to
high scores and intervene with appropriate changes in clinical management.*The
Clinical Scoring function helps a clinician quickly determine the severity of illness of a
patient based on a calculated score, so that the clinician can take necessary measures
according to the indication provided by the Clinical Scoring function.
The monitor supports the following scorings:
■ MEWS (Modified Early Warning Score)
■ NEWS (National Early Warning Score)
■ Customizable Score
• The Clinical Score is intended to be used only by healthcare professionals and
to be serviced by trained personnel.
• The scores and clinical responses in the clinical scores are for reference and
cannot be alone used for diagnostic interpretation.
• Both MEWS and NEWS are not applicable to pregnant woman, COPD (Chronic
Obstructive Pulmonary Disease) patients and those under 16 years old.
*Please also refer to Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a
modified Early Warning Score in medical admissions. Quarterly Journal of Medicine
2001; 94: 521–526.
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