Marjon Borgert

50 Chapter 3 Table 1. The Modi ed Early Warning Score (MEWS) 4 MEWS score 3 2 1 0 1 2 3 Respiratory rate <9 9-14 15-20 21-30 >30 Saturation with adequate oxygen therapy < 90 Heart rate <40 40-50 51-100 101-110 111-130 >130 Systolic blood pressure <70 70-80 81-100 101-200 >200 AVPU score A (Alert) V (response to Voice) P (reacting to Pain) U (Unres- ponsive) Temperature <35.1 35.1-36.5 36.6-37.5 >37.5 Urine production below 75 mL during previous 4 hours: 1 point Worried about patient’s condition: 1 point Upon reaching 3 or more points → call resident in charge CAT registrations All CAT activations are real-time registered in an electronic database ‘Advanced Life Support Information System’ according to the Utstein guidelines. 10 Data belonging to the AE (i.e. patient characteristics, rst observed symptoms, location of collapse, cause of the AE, clinical outcomes) are recorded at the bedside by a nurse who participates in the CAT. Classifying observations The symptoms that were used to determine the level of urgency of the FAs were systolic blood pressure, Glasgow Coma Score (GCS) and respiratory status. The vital signs are directly recorded in standard categories in the database (Table 2). The data was registered and stored in the electronic database and the calls categorised as ‘urgent’ or ‘less urgent’. Calls were classi ed as urgent when at least one of the following observations was registered: 1) Systolic blood pressure levels between 50 and 75 mmHg or not palpable 16,17 , or 2) GCS < 9 18 , or 3) assumed apnoea or gasping. 8,19 Calls were classi ed as less urgent when all of the following observations were present: 1) Palpable systolic blood pressure or levels ≥ 76 mmHg 16,17 , and 2) GCS ≥ 9 18 and 3) breathing normally or with e ort. 8,19