The Count Outreach Warning Score (COWS) can be used to identify a patient who may require a "step up" in care such as admission to the ICU. The authors are from Chelsea Hospital in London.
Parameters:
(1) temperature
(2) oxygen saturation on room air
(3) urine output
(4) heart rate
(5) respiratory rate
(6) mental status
|
Parameter |
Finding |
Points |
|
temperature |
< 35°C |
1 |
|
|
35 - 39°C |
0 |
|
|
> 39°C |
1 |
|
oxygen saturation |
>= 95% |
0 |
|
|
< 95% |
1 |
|
urine output |
>= 30 mL per hour |
0 |
|
|
< 30 mL per hour |
1 |
|
heart rate |
< 51 beats per minute |
1 |
|
|
51 - 99 beats per minute |
0 |
|
|
> 99 beats per minute |
1 |
|
respiratory rate |
<= 19 breaths per minute |
0 |
|
|
> 19 breaths per minute |
1 |
|
mental status |
alert |
0 |
|
|
responds to voice |
1 |
|
|
responds to physical stimulus |
1 |
|
|
unresponsive |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A total score >= 3 was considered "positive" for the patient requiring more aggressive management.
Specialty: Critical Care, Emergency Medicine
ICD-10: ,
