A national early warning score for acutely ill patients

The critical care unit, which clusters patients with life threatening illness in a single geographical area, is now a familiar concept. It offers patients the best chance of survival through optimum technology and the concentration of clinical skills and experience. Critical care medicine is a specialty that depends largely on a resource intensive environment. Until recently, for both economic and practical reasons, critical care could not be provided for every hospital inpatient. As the specialty has developed, it has repeatedly been noted that poor outcomes commonly result from a failure to promptly recognise and treat patients who become acutely ill on a standard hospital ward. As part of a long term strategy to tackle this problem, the Royal College of Physicians has launched a national early warning score.1 This is a welcome development that may be good news for patients. However, it is worth highlighting some potential pitfalls.

Patients die not from their disease but from the disordered physiology caused by the disease. The early warning score is an established tool that uses this concept …