Carle et al developed an early warning score (EWS) for obstetrical patients. This takes into account the changes that pregnancy has on the physiologic response to illness. The authors are from Peterborough City Hospital, University Hospital of South Manchester and Stepping Hill Hospital in England.
Parameters (collected during the first 24 hours after a critical care admission):
(1) systolic blood pressure in mm Hg
(2) diastolic blood pressure in mm Hg
(3) respiratory rate in breaths per minute
(4) heart rate in beats per minute
(5) FIO2 need to keep oxygen saturation >= 96%
(6) body temperature in °C
(7) level of consciousness
|
Parameter |
Finding |
Points |
|
systolic blood pressure |
>= 160 |
3 |
|
|
150 to 159 |
2 |
|
|
140 to 149 |
1 |
|
|
90 to 139 |
0 |
|
|
80 to 89 |
2 |
|
|
< 80 |
3 |
|
diastolic blood pressure |
>= 110 |
3 |
|
|
100 to 109 |
2 |
|
|
90 to 99 |
1 |
|
|
< 90 |
0 |
|
respiratory rate |
>= 30 |
3 |
|
|
25 to 29 |
2 |
|
|
18 to 24 |
1 |
|
|
10 to 17 |
0 |
|
|
< 10 |
3 |
|
heart rate |
>= 150 |
3 |
|
|
111 to 149 |
2 |
|
|
60 to 110 |
0 |
|
|
< 60 |
3 |
|
FIO2 |
room air (0.21 to 0.23) |
0 |
|
|
0.24 to 0.39 |
1 |
|
|
>= 0.40 |
3 |
|
temperature |
>= 39 |
3 |
|
|
38 to 38.9 |
1 |
|
|
35.1 to 37.9 |
0 |
|
|
34 to 35 |
1 |
|
|
< 34 |
3 |
|
consciousness |
alert (GCS = 15) |
0 |
|
|
not alert (GCS < 15) |
3 |
total score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the greater the risk.
|
Score |
Risk Group |
Monitoring |
|
0 |
very low |
routine |
|
1 to 3 |
low |
minimum q4h; alert nurse in charge |
|
4 or 5, or 1 parameter scores 3 |
medium |
minimum q1h; alert medical team |
|
>= 6 |
high |
continuous monitoring; emergency response team |
Purpose: To evaluate an obstetrical patient in the hospital using the early warning score of Carle et al.
Objective: risk factors, severity, prognosis, stage
ICD-10: ,
