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An early warning? Universal risk scoring in emergency medicine
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  • Published on:
    Over dependence on Early Warning Scores in the Emergency Department

    Dear Sir

    I read with interest the recent articles discussing the use of early warning scores (EWS) in the Emergency Department (ED).[1, 2] Whilst I agree with the observation that their current use in the ED is flawed, I would suggest there is perhaps a dangerous overdesire to seek out a 'system to recognise the sick patient'. Arguably this 'system' should be already in place - that is the nursing and medical t...

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    Conflict of Interest:
    None declared.
  • Published on:
    Track and trigger - is it really a false trail?

    Sir

    Dr Roland and Prof Coats raise some interesting reservations regarding the adoption of hospital-wide track and trigger systems (TTS), but I must take issue with some of their pessimism.

    They argue that the application of TTSs in the ED will be limited by the difference between the inpatient derivation sets of the TTS and the ED population. I am not convinced that our patient populations are so dif...

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    Conflict of Interest:
    None declared.
  • Published on:
    Early Warning scores do have a role to play in the ED

    Dear Sir

    The commentary on early warning scores in the ED presents an interesting viewpoint on their use. NCEPOD, NICE and CEMACH all recommend the use of track and trigger systems in acute hospital settings, a Department of Health review found that most NHS trusts were using aggregate weighting systems such as Modified Early Warning Scores (MEWS) (1). MEWS have been validated in the medical and surgical ward s...

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    Conflict of Interest:
    None declared.