Modified Early Warning Score (MEWS)
5-parameter early warning score for detecting clinical deterioration in hospitalised adults. Precursor to NEWS. Score ≥5 = requires urgent review; score ≥4 = consider ICU/HDU transfer.
Score interpretation
MEWS 0–2 — low risk; routine monitoring
→ Continue routine observations; frequency as per admission plan; document and re-chart regularly
MEWS 3–4 — consider increased monitoring
→ Increase monitoring frequency to hourly; ward doctor review; assess fluid balance and urine output; initiate investigations; consider sepsis 6 bundle if infection suspected
MEWS ≥5 — urgent medical review required
→ Immediate senior medical review; consider ICU/HDU transfer; ABCDE assessment; IV access and blood tests (FBC, CRP, lactate, cultures, ABG); NEWS2 preferred for ongoing monitoring; critical care outreach referral
Interpretation bands for the MEWS. Apply clinical judgement and local guidance.
References
- Subbe CP et al. Validation of a modified Early Warning Score in medical admissions. QJM. 2001;94(10):521–526.
Related
Curated clinical cross-links plus same-class fallbacks.
- Hydrocortisone (Oral Replacement) · Glucocorticoid Replacement
- Morphine (Oral) · Strong Opioid Analgesic — Step 3 WHO Ladder
- Oxycodone · Strong Opioid Analgesic — Step 3 WHO Ladder
- Donanemab (Anti-Amyloid Monoclonal Antibody) · Anti-Amyloid Immunotherapy (IgG1 — Targets Pyroglutamate-Modified Amyloid-β)
- Melatonin Modified-Release (Elderly Insomnia) · Melatonin Receptor Agonist — Hypnotic
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Rapid Sequence Induction (RSI) · DAS 2015 / AAGBI
- ICU Sedation and Analgesia · SCCM / NICE CG83
- Vasopressor Escalation in Shock · Surviving Sepsis Campaign 2021
- Tracheostomy Management · NTSP / ICS guidelines
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.