• James R Griffiths and Elizabeth M Kidney.
• Barnsley Hospital NHS Foundation Trust, Department of Emergency, Barnsley, UK. jamesgriffiths@nhs.net
• Emerg Med J. 2012 Jan 1;29(1):65-6.

BackgroundThere 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.ObjectiveTo assess use of MEWS in UK EDs.MethodsA 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.ResultsResponses 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.ConclusionDespite 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.

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