ARCHETYPE Modified Early Warning Score (NT RMP) (openEHR-EHR-OBSERVATION.mews_nt_rmp.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.mews_nt_rmp.v1
ConceptModified Early Warning Score (NT RMP)
DescriptionA simple score used to provide an objective indication of the degree of illness of a patient. This version is used by the Remote Medical Practitioner On-Call service in the Northern Territory, Australia.
UseUse to record a composite score to support assessmennt of the degree of illness in an unwell patient. MEWS is based on data derived from four physiological readings (systolic blood pressure, heart rate, respiratory rate, body temperature) and one observation (level of consciousness) which are compared to normal ranges. The score for each parameter is added to generate a single composite score. Different MEWS are in use in different jurisdictions in Australia and in other parts of the world. This version of MEWS is mandated for use by the Remote Medical Practitioner On-Call service in the Northern Territory, Australia to support remote clincians to determine the degree of illness in a unseen patient and the need for emergency retrieval.
MisuseNot to be used to record each physical measurement or clinical observation. Use specific OBSERVATION archetypes for this purpose - OBSERVATION.blood_pressure, OBSERVATION.heart_rate, OBSERVATION.respirations, OBSERVATION.body_temperature, OBSERVATION.avpu and OBSERVATION.glasgow_coma.
PurposeTo record provide a composite score based on categorising physiological readings and observations, as a simple method to support objective assessment of the degree of illness in an unwell patient.
ReferencesProfessional Practice Group. Remote Health Atlas: Managing Retrievals [PDF]. Northern Territory Government, Department of Health & Families; October 2009. Available from: http://remotehealthatlas.nt.gov.au/appendix_mews.pdf.
Copyright© openEHR Foundation
AuthorsAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2013-02-07
Other Details LanguageAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2013-02-07
OtherDetails Language Independent{references=Professional Practice Group. Remote Health Atlas: Managing Retrievals [PDF]. Northern Territory Government, Department of Health & Families; October 2009. Available from: http://remotehealthatlas.nt.gov.au/appendix_mews.pdf., current_contact=Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com, MD5-CAM-1.0.1=DDFF49EF2C6204C383C658596BFDC4B4}
KeywordsMEWS, warning, AVPU, RR, HR, BP, Temp, SBP
LifecycleCommitteeDraft
Language useden
Citeable Identifier1013.1.1437
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=A simple score used to provide an objective indication of the degree of illness of a patient. This version is used by the Remote Medical Practitioner On-Call service in the Northern Territory, Australia., archetypeConceptComment=null, otherContributors=, originalLanguage=en, translators=, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=EVENT, level=2, text=Any event, description=Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], context=[], capabilities=[], activities=[], protocol=[], identities=[], source=[], credentials=[], state=[], items=[], contacts=[], target=[], relationships=[], description=[], ism_transition=[], content=[], details=[], other_participations=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Systolic Blood Pressure, description=Range category for the systolic blood pressure (SBP) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 101-199 [The systolic blood pressure measurement is between 101 and 199 mmHg; scored as 0 points.]
1: 81-100 [The systolic blood pressure measurement is between 81 and 100 mmHg; scored as 1 point.]
2: 71-80 or >199 [The systolic blood pressure measurement is between 71 and 80 mmHg or greater than 199 mmHg; scored as 2 points.]
3: <70 [The systolic blood pressure measurement is less than 70 mmHg; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Heart Rate, description=Range category for the heart rate (HR) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 51-100 [The heart rate measurement is between 51 and 100 beats/min; scored as 0 points.]
1: 41-50 or 101-110 [The heart rate measurement is between 41 and 50 beats/min or between 101 and 110 beats/min; scored as 1 point.]
2: <40 or 111-129 [The heart rate measurement is less than 40 beats/min or between 111 and 129 beats/min; scored as 2 points.]
3: >129 [The heart rate measurement is greater than 129 beats/min; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Respiratory Rate, description=Range category for the respiratory rate (RR) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 9-14 [The respiratory rate measurement is between 9 and 14 breaths/min; scored as 0 points.]
1: 15-20 [The respiratory rate measurement is between 15 and 20 breaths/min; scored as 1 point.]
2: <9 or 21-29 [The respiratory rate measurement is less than 9 breaths/min or between 21 and 29 breaths/min; scored as 2 points.]
3: >29 [The respiratory rate measurement is greater than 29 breaths/min; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0007], code=at0007, itemType=ELEMENT, level=4, text=Temperature, description=Range category for the body temperature (Temp) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 35-38.4 [The body temperature measurement is between 35 and 38.4 degrees Celsius; scored as 0 points.]
2: <35 or >38.4 [The body temperature measurement is less than 35 degrees Celsius or greater than 38.4 degrees Celsius; scored as 2 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=AVPU, description=Observed category for the AVPU scale rating of a patient's conscious state., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: A [The patient is alert or awake.]
1: V [The patient responds to verbal stimulus.]
2: P [The patient responds to painful stimulus.]
3: U [The patient is unconscious and not responding to stimulation.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0028], code=at0028, itemType=ELEMENT, level=4, text=Total Score, description=The composite total score of each MEWS parameter category., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0; max: <=13

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2: 71-80 or >199 [The systolic blood pressure measurement is between 71 and 80 mmHg or greater than 199 mmHg; scored as 2 points.]
3: <70 [The systolic blood pressure measurement is less than 70 mmHg; scored as 3 points.]
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2: <40 or 111-129 [The heart rate measurement is less than 40 beats/min or between 111 and 129 beats/min; scored as 2 points.]
3: >129 [The heart rate measurement is greater than 129 beats/min; scored as 3 points.]
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2: <9 or 21-29 [The respiratory rate measurement is less than 9 breaths/min or between 21 and 29 breaths/min; scored as 2 points.]
3: >29 [The respiratory rate measurement is greater than 29 breaths/min; scored as 3 points.]
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2: P [The patient responds to painful stimulus.]
3: U [The patient is unconscious and not responding to stimulation.]
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