MEWS Calculator — Modified Early Warning Score
Calculate the Modified Early Warning Score (MEWS) from systolic blood pressure, heart rate, respiratory rate, temperature and AVPU level of consciousness, with the risk level and escalation threshold of 5.
How it works
MEWS = SBP (≤ 70: 3, 71–80: 2, 81–100: 1, 101–199: 0, ≥ 200: 2) + HR (≤ 40: 2, 41–50: 1, 51–100: 0, 101–110: 1, 111–129: 2, ≥ 130: 3) + RR (< 9: 2, 9–14: 0, 15–20: 1, 21–29: 2, ≥ 30: 3) + temperature (< 35 °C: 2, 35–38.4: 0, ≥ 38.5: 2) + AVPU (alert 0, voice 1, pain 2, unresponsive 3). Total 0–14; ≥ 5 = high risk.
The Modified Early Warning Score (Subbe et al., QJM 2001) is a bedside track-and-trigger score built from five routine observations. In medical admissions a score of 5 or more was linked to a higher risk of death and ICU admission, so many hospitals use 5 as the trigger for urgent medical review, with 3–4 prompting more frequent observations. Local escalation policies vary, and many UK hospitals now use NEWS2 instead.
Worked example
A patient has systolic BP 95 mmHg (1), heart rate 112 (2), respiratory rate 22 (2), temperature 38.2 °C (0) and is alert (0): MEWS = 1 + 2 + 2 + 0 + 0 = 5 / 14 — high risk, reaching the usual threshold for urgent medical review.
Sources: Subbe CP et al. Validation of a modified Early Warning Score in medical admissions. QJM 2001
Frequently asked questions
What MEWS score is concerning?
A MEWS of 5 or more was associated with increased mortality and ICU admission in the original study and is the most common trigger for urgent review. Many hospitals also act on any single parameter scoring 3.
What does AVPU mean?
Alert, responds to Voice, responds to Pain, Unresponsive — a quick way to grade level of consciousness. Anything other than alert adds points.
What is the difference between MEWS and NEWS2?
NEWS2 adds oxygen saturation and supplemental oxygen and uses different bands; MEWS uses five observations. Both aim to detect deterioration early — use the score your hospital’s policy is built on.
Does MEWS replace clinical judgement?
No. A low score does not rule out a sick patient, and staff should escalate whenever they are worried, whatever the number.
Related calculators
Clinical decision tool for education and for use by trained clinicians alongside clinical judgement — not a diagnosis and not a substitute for medical assessment. Scores validated in specific populations may not apply to every patient.