**2.4 Modified early warning score (MEWS)**

The modified early warning score (MEWS) evaluates temperature, pulse, respiratory rate, systolic blood pressure, and level of consciousness by the AVPU score (Alert, Reacting to Voice, Reacting to Pain, or Unresponsive). Each parameter is assigned a score from zero to three based on the degree of abnormality and then parameters are aggregated as a MEWS score. Different scoring thresholds trigger pre-determined interventions. For example, a score of 3 may recommend increasing frequency of patient assessment to every 8 hours. MEWS has been validated for use in all hospitalized patients with its parameters easily attainable at bedside allowing for generalized use [9]. MEWS at a cut-point of 4 demonstrated higher sensitivity when utilized with a clinician's input compared with using MEWS with a cutoff score of 4 alone (56.6% vs. 72.4%) [10]. This highlights the need for clinical context when utilizing a deterioration score for decision-making.
