We do Teamevaluation and use the ESI Triage Score. Early Warning Scores are recommended for Patients onwards but not in ED. Is it usefull to use them early in the ED, especially before transition. If the cutpoint is reached we could stop the transition to make a reevaluation or maybe an ICU transfer.
Very interesting question Thomas. I'm still a bit new to ED research, so excuse my ignorance... Where were EWS's developed (outside of ED presumably)? Perhaps the way to investigate if such a system would work in the ED would be to look at patients who did not go to ICU from ED but shortly afterwards (say
Hello John, in 2007, the National Institute for Health and Clinical Excellence recommended that physiologic track and trigger systems should be used to monitor all adult patients in acute hospital settings. These systems, also known as early warning scores, typically
use vital sign thresholds to identify at-risk patients. They were developed to monitor ward Patients and if the cut point is reached to activate a Rapid response Team for evaluation. And yes I try to get the number of patients they dont went initially to ICU from ED but shortly afterwards.
I have felt that the MEWS (Modified Early Warning System) for adult ED patients is a great tool for early detection for patients who may require the activation of the Rapid Response Team. PEWS (Pediatric Early Warning Scores) is also effective and specific to the pediatric population. These scores are not yet but should be a standard for any patient who is being admitted or transferred to another facility with continual updates in the score in order for early detection of any deterioration in a patient's physiological status.
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