How it's calculated
Each of 5 parameters (systolic BP, heart rate, respiratory rate, temperature, and AVPU consciousness level) is scored 0-3 against its normal range, and the 5 scores are summed.
Interpretation
| Score | Interpretation |
|---|---|
| 0-2 | Low concern |
| 3-4 | Increased concern — more frequent observation |
| ≥ 5 | High concern — commonly used trigger for urgent review |
Clinical use
- An earlier ward-based deterioration/track-and-trigger score, still in use at some institutions, that predecessor to and inspired NEWS2.
- Used to standardise the frequency of observations and to trigger escalation (e.g. calling a doctor or rapid-response team) based on a rising score.
- Exact score thresholds and required actions vary between hospitals and countries — always confirm against your local early-warning-score policy rather than assuming these bands apply directly.
Frequently asked questions
How is MEWS different from NEWS2?
NEWS2 is a later, more rigorously validated and standardised early warning score (used across the UK NHS and increasingly elsewhere) that added SpO2 and supplemental oxygen use as parameters and has more consistent scoring bands — many institutions that used MEWS have since transitioned to NEWS2.
What does AVPU stand for?
Alert, responds to Voice, responds to Pain, Unresponsive — a quick, simplified assessment of consciousness level used in early warning scores, less detailed than the full Glasgow Coma Scale.
What score should trigger an urgent review?
Commonly a total of 5 or more, though exact institutional trigger points vary — check your local early-warning-score protocol.
References
- Subbe CP, et al. Validation of a modified Early Warning Score in medical admissions. QJM. 2001;94(10):521-526.