An early warning score (EWS) is a guide used by medical services to quickly determine the rate of the patient's illness. It is based on six cardinal vital signs (respiratory rate, oxygen saturation, temperature, blood pressure, pulse/heart rate, AVPU response) and one other observation.
Video Early warning score
Dasar dari EWS
The observed results were compared with the normal range to produce a single composite score, for example based on the following diagram:
A score of five or more was statistically associated with a possible increase in mortality or admission into an intensive care unit.
In the hospital, the EWS is used as part of a "track-and-trigger" system in which increased scores generate increased responses varying from increased patient-observation frequency (for low scores) to urgent review by rapid response or Emergency Medical Team MET).
Maps Early warning score
The ideal EWS
Around the world EWS is based on the principle that clinical damage can be seen through changes in various physiological measurements, as well as major changes in one variable. However, these scales are calibrated to different populations and sometimes extended to include additional parameters, specific to different parts of the world. Parameter values ​​may vary, as well as weighting scores for worsening worsening. Some systems also assign scores for other parameters including urine output, oxygen saturation, oxygen delivery rate and pain score.
There is no consensus on what constitutes an 'ideal' early warning score system. Comparing the different systems in clinical use shows the variation in which the parameters are scored and how the score is set for different levels of damage. However there is some evidence that certain parameters are better at predicting patients who will die within 24 hours than others. This has led to calls in some countries for the development of national early warning scores that will allow a standard approach to assessing and responding to deteriorating patients.
Variation of Early Warning Score
Early Warning Scores have been developed in response to the needs of certain types of patients (eg PEWS for children) or to support local best practice (NEWS in the UK).
Ini termasuk:
Variasi wilayah
Leeds Teaching Hospitals Trust (LTHT), Inggris 2011
(accurate as of February 2011)
Wellington Hospital, New Zealand 2012
(accurate as of January 2012)
This matrix connects MEWS with the colored band corresponding to the one in the observation chart. It not only provides visual cues for damage but also makes it easier to set the score after color is learned.
The system also shows a 'single parameter' trigger where extreme breakdown results in a mandatory MET call that ensures immediate attendance by the Emergency Medical Team Team to the side of the patient's most ill bed.
National Early Warning Values, UK
In the UK, the Royal College of Physicians has introduced a national early warning score (NEWS) to replace local or regional scores. NEWS scores are the largest national EWS effort today, but are still problematic in the UK due to the lack of universal implementation capabilities (having exclusion criteria) and not yet having published retrospective validation studies. Sundesvall Regional Hospital Sundsvall, Sweden Sundsvall Regional Hospital, Sweden
The following parameters are used to estimate MEWS at Sundsvall Regional Hospital, Sweden:
The following are guidelines for re-estimating MEWS:
See also
- Glasgow Coma Scale
- Trial
References
External links
- Modified Online Early Warning Score
- National Early Warning Score online
Source of the article : Wikipedia
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