Medical Post - Early Warning.

Early Warning Scores have swept across hospitals in the British Isles and beyond. They help warn hospital ward staff of the severity of a patients illness, and whether their condition is getting better or worse. Most focus on recording heart rate, breathing rate, blood pressure, temperature, the amount of oxygen in the blood and how awake the patient is. A number is derived and if high enough this can tell the medical staff that the patient needs to be transferred to a high dependency or intensive care unit. Lower scores however, can tell the hospital staff that the patient is getting worse and measures need to be taken. These could include giving more fluids, blood, oxygen etc.
This all seems very sensible. There is good evidence that these scores help doctors and nurses identify sick patients more quickly. Earlier acute treatment has been shown to save lives. However, Early Warning Scores have only been proven to reduce the number of deaths in hospitals if at the same time you also introduce a Critical Care Outreach Team or Emergency Medical Team. These are groups of specially trained doctors, nurses, physiotherapists etc. who know how to treat very sick acutely ill patients. It does seem obvious that it's not enough to just score a patient and realise how ill they are if you then do not know what to do about it! In July 2007 NICE published it's guidance "Acutely Ill Patients in Hospital" in which it recommended that there should be a "team with critical care competencies and diagnostic skills. The team should include a medical practitioner skilled in the assessment of the critically ill patient, who possesses advanced airway management and resuscitation skills. There should be an immediate response."
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