emergency infectious-disease

MEDS — Mortality in Emergency Department Sepsis

Predicts 28-day mortality in adult ED sepsis (Shapiro 2003). Sums 9 weighted criteria.

Score interpretation

Very low risk (<2% 28-day mortality) 0–4

→ Source control, antibiotics within 1 h per Sepsis Six, fluids and disposition planning. Ward-level care often appropriate.

Low risk (~3% mortality) 5–7

→ Sepsis Six bundle; admit for observation; monitor lactate trend.

Moderate risk (~7% mortality) 8–12

→ Critical care review; aggressive resuscitation; vasopressors if MAP <65 after 30 mL/kg crystalloid; hourly NEWS2.

High risk (~16% mortality) 13–15

→ Direct ICU admission; senior anaesthetic and ICU review; central access; consider early intubation if airway compromise.

Very high risk (>30% mortality) 16–27

→ Immediate ICU; consider treatment escalation discussion / advance care plan; aggressive bundle compliance + early infectious-disease input.

Interpretation bands for the MEDS. Apply clinical judgement and local guidance.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.