Early warning score

Early Warning Score (EWS)

The Early Warning Score (EWS) is a clinical risk management protocol used by healthcare services to assess the acute illness level of patients. It is a crucial tool that aids in early detection of potential clinical deterioration.

Background

The development of EWS systems originated in the late 1990s, following clinical studies which revealed that serious in-hospital events, such as cardiac arrest and other forms of acute deterioration, were often foreshadowed by observable deviations in a patient's vital signs. These findings catalyzed the formulation of various scoring systems aimed at facilitating the early recognition and response to clinical decline.

Vital Signs Monitored

The EWS is predicated on the regular monitoring of six primary vital signs:

• Respiratory rate
• Oxygen saturation
• Temperature
• Blood pressure
• Pulse/heart rate
• AVPU response (an acronym for "Alert, Voice, Pain, Unresponsive")

Each parameter is scored independently, with the cumulative score providing a quantifiable index of the patient's overall status.

Implementation and Usage

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An example of an Early Warning Score chart.

Upon implementation, healthcare providers are trained to measure and interpret these vital signs and are provided with EWS charts, like the one pictured, to log and calculate scores systematically. The resulting score is used to guide clinical decisions, including the urgency of response and the need for escalation of care to more specialized services or interventions.

Importance and Impact

The EWS has been instrumental in improving patient outcomes by providing a standardized method for early detection of patient deterioration. By alerting clinicians to early signs of a decline, the EWS facilitates timely interventions that can prevent further decline, potential intensive care admission, and even death.

See Also

• Patient monitoring
• Clinical deterioration
• Medical emergency

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