title: Early warning scores: unravelling detection and escalation.
abstract: OBJECTIVE
  The purpose of this paper is to increase understanding of how patient deterioration is detected and how clinical care escalates when early warning score (EWS) systems are used.
  
  
  METHODS
  The authors critically review a recent National Early Warning Score paper published in IJHCQA using personal experience and EWS-related publications, and debate the difference between detection and escalation.
  
  
  RESULTS
  Incorrect EWS choice or poorly understood EWS escalation may result in unnecessary workloads forward and responding staff.
  
  
  CONCLUSIONS
  EWS system implementers may need to revisit their guidance materials; medical and nurse educators may need to expand the curriculum to improve EWS system understanding and use.
  
  
  CONCLUSIONS
  The paper raises the EWS debate and alerts EWS users that scrutiny is required.
authors.affiliation: Centre of Postgraduate Medical Research and Education (CoPMRE), Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.
authors.forename: Gary B
authors.initials: GB
authors.lastname: Smith
authors.forename: David R
authors.initials: DR
authors.lastname: Prytherch
authors.forename: Paul
authors.initials: P
authors.lastname: Meredith
authors.forename: Paul E
authors.initials: PE
authors.lastname: Schmidt
mesh_terms: D001794:Blood Pressure; D001831:Body Temperature; D002985:Clinical Protocols; D003243:Consciousness; D016638:Critical Illness; D018450:Disease Progression; D006801:Humans; D010100:Oxygen / Q000097:blood; D011674:Pulse; D012119:Respiration
chemical_list: D010100:Oxygen
keywords: Adverse events; Cardiac arrest; Death; Early warning scores; Intensive care unit admission; National Early Warning Score; Rapid response teams