Current use of early warning scores in UK emergency departments

Background There is recent evidence that the modified early warning scoring systems (MEWS) in the emergency department (ED) can identify patients at risk of deterioration. However, concerns remain that they are not sensitive enough to use as a risk assessment tool. Objective To assess use of MEWS in UK EDs. Methods A postal survey was undertaken of 254 adult EDs within the UK. Questionnaires were sent to the clinical lead at each department about their use of early warning scoring systems. Results Responses were received from 145 departments giving a response rate of 57%. 87% of respondents are currently using early warning scores (EWS). Of those, 80% are using MEWS. In 71% high EWS results in senior ED review, however in 25% it does not. Less than half of departments use high MEWS to trigger critical care input. 93% of respondents support using EWS in the ED. Conclusion Despite the lack of strong evidence, the majority of UK EDs are using EWS in some form. MEWS is the most commonly used but departments vary on their use of EWS for senior ED and/or critical care review. Over 90% of respondents in this survey support EWS in the ED.