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Clinical Early Warning Scores: New Clinical Tools in Evolution



D. John Doyle*
Department of General Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic Abu Dhabi, UAE


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© 2018 D. John Doyle.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of General Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Consultant, Cleveland Clinic Abu Dhabi, UAE; Tel: +971 (0)52 699 7627; E-mail: djdoyle@hotmail.com


Abstract

Clinical Early Warning Scores are tools intended to alert clinical staff to possible future clinical deterioration, often related to the onset of sepsis. Since their introduction, they have increased greatly in popularity. Their operation is conceptually simple: an elevated early warning score triggers a formal assessment by the responsible clinician. While the best-known system is the Royal College of Physicians National Early Warning Score (NEWS), a number of other scores are in use, such as an adaptation known as the Modified Early Warning System (MEWS) or warning systems for pediatric patients (PEWS). However, while promising, such instruments need to be studied in more detail to better characterize their eventual role in monitoring hospital patients. In particular, a central question concerns the identification of the best system (NEWS, MEWS, PEWS etc.) for a given clinical population (pediatric, trauma, prehospital etc.).

Keywords: Clinical Early Warning Score, Clinical deterioration, Patient monitoring, Patient safety, Sepsis, Pediatric patients.