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Date Date Maternity MEWS Surname: ...... NHI: ...... Vital Signs Time (24 hour) Time (24 hour) First Names:...... ≥ 31 ≥ 31 Date of Birth: ...... /...... /...... Sex: ...... Respiratory Rate 26-30 3 26-30 PLACE PATIENT ID HERE (breaths/min) 21-25 2 21-25 10-20 0 10-20

...... THIS CHART IS FOR PREGNANT OR RECENTLY PREGNANT WOMEN ONLY (WITHIN 42 DAYS) ...... write RR value 6-9 3 6-9 ≤ 5 ≤ 5 ESCALATE CARE FOR: NHI:

. Sex: Oxygen Room air X 0 Room air X • ANY WOMAN YOU, THEY OR THEIR FAMILY ARE WORRIED ABOUT, (L/min) value Supplement (L/min) 2 Supplement (L/min) REGARDLESS OF VITAL SIGNS OR EARLY WARNING SCORE ...... / Oxygen ≥ 95 0 ≥ 95 • ACUTE FETAL CONCERN Saturation(%) 92-94 2 92-94 ...... write SpO value 3 / 2 ≤ 91 ≤ 91 ≥ 140s ≥ 140s Mandatory escalation pathway - maternity PLACE PATIENT ID HERE PLACE PATIENT 3 130s Maternity Early Warning Score ......

. Action 2 (MEWS) ......

. 120s ......

. 110s Heart Rate 1 (bpm) 100s MEWS 1-4 90s 80s 0 Surname: Surname: First Names: Date Birth: of mark HR with X 70s 70s write value if off scale 60s 60s MEWS 5-7 50s 1 50s 40s 3 40s Acute illness or unstable ≤ 30s ≤ 30s chronic disease ≥ 200s ≥ 200s SIDE 1 190s 190s MEWS 8-9 180s 180s 3 or any vital sign in pink zone 170s 170s 160s 160s Likely to deteriorate rapidly Systolic Blood 150s 150s 2 Pressure 140s 140s MEWS 10+ (mmHg) 130s 130s or any vital sign in blue zone 120s 120s 0 mark SBP with X 110s 110s Immediately life threatening write value if off scale 100s 100s critical illness 90s 1 90s 80s 2 80s A full set of vital signs with corresponding MEWS must be taken and calculated each 3 70s 70s time at the frequency stated in policy. If there is no timely response to your request for 60s 60s review, escalate to the next coloured zone. ≤ 50s ≤ 50s ≥ 110s 3 ≥ 110s 100s 100s Modification to Maternity Early Warning Score (MEWS) Triggers Diastolic Blood 2 90s 90s Pressure The MEWS can be changed to prevent inappropriate escalation. 80s 80s (mmHg) All modifications should be made in line with local policy and 70s 70s regularly reviewed by the responsible clinician. mark DBP with X 60s 0 60s write value if off scale 50s 50s Query any modification that is not signed and dated. ≤ 40s ≤ 40s Vital sign Accepted values and Date and Name and contact ≥ 39s 3 ≥ 39s Duration (use abbreviation) modified MEWS time (hours) details Temperature 38s 1 38s o / / ( C) 37s 37s 0 : mark Temp with X 36s 36s 35s 1 35s WOMEN WHOUSE NOT REQUIRE OBSERVATIONS. FOR THIS REPEATED ROUTINE CHART INTRAPARTUM FOR PREGNANT/POSTNATAL USE MATERNITY VITAL SIGNS CHART SIGNS VITAL MATERNITY write value if off scale Reason: ≤ 34s 3 ≤ 34s / / Level of Normal 0 Normal Consciousness : mark LOC with X Abnormal 3 Abnormal Reason: MATERNITY EARLY WARNING SCORE TOTAL MEWS TOTAL or apply exemption (EX) or EX / / Pain score Rest Rest : (0-10) Movement Movement Initials Reason: Date Date Maternity MEWS Surname: ...... NHI: ...... Vital Signs Time (24 hour) Time (24 hour) First Names:...... ≥ 31 ≥ 31 Date of Birth: ...... /...... /...... Sex: ...... Respiratory Rate 26-30 3 26-30 PLACE PATIENT ID HERE (breaths/min) 21-25 2 21-25 10-20 0 10-20

...... THIS CHART IS FOR PREGNANT OR RECENTLY PREGNANT WOMEN ONLY (WITHIN 42 DAYS) ...... write RR value 6-9 3 6-9 ≤ 5 ≤ 5 ESCALATE CARE FOR: NHI:

. Sex: Oxygen Room air X 0 Room air X • ANY WOMAN YOU, THEY OR THEIR FAMILY ARE WORRIED ABOUT, (L/min) value Supplement (L/min) 2 Supplement (L/min) REGARDLESS OF VITAL SIGNS OR EARLY WARNING SCORE ...... / Oxygen ≥ 95 0 ≥ 95 • ACUTE FETAL CONCERN Saturation(%) 92-94 2 92-94 ...... write SpO value 3 / 2 ≤ 91 ≤ 91 ≥ 140s ≥ 140s Mandatory escalation pathway - maternity PLACE PATIENT ID HERE PLACE PATIENT 130s 3 130s Maternity Early Warning Score ......

. Action 2 (MEWS) ......

. 120s 120s ......

. 110s 110s Heart Rate 1 (bpm) 100s 100s MEWS 1-4 90s 90s 80s 80s 0 Surname: Surname: First Names: Date Birth: of mark HR with X 70s 70s write value if off scale 60s 60s MEWS 5-7 50s 1 50s 40s 3 40s Acute illness or unstable ≤ 30s ≤ 30s chronic disease ≥ 200s ≥ 200s SIDE 2 190s 190s MEWS 8-9 180s 180s 3 or any vital sign in pink zone 170s 170s 160s 160s Likely to deteriorate rapidly Systolic Blood 150s 150s 2 Pressure 140s 140s MEWS 10+ (mmHg) 130s 130s or any vital sign in blue zone 120s 120s 0 mark SBP with X 110s 110s Immediately life threatening write value if off scale 100s 100s critical illness 90s 1 90s 80s 2 80s A full set of vital signs with corresponding MEWS must be taken and calculated each 3 70s 70s time at the frequency stated in policy. If there is no timely response to your request for 60s 60s review, escalate to the next coloured zone. ≤ 50s ≤ 50s ≥ 110s 3 ≥ 110s 100s 100s Modification to Maternity Early Warning Score (MEWS) Triggers Diastolic Blood 2 90s 90s Pressure The MEWS can be changed to prevent inappropriate escalation. 80s 80s (mmHg) All modifications should be made in line with local policy and 70s 70s regularly reviewed by the responsible clinician. mark DBP with X 60s 0 60s write value if off scale 50s 50s Query any modification that is not signed and dated. ≤ 40s ≤ 40s Vital sign Accepted values and Date and Name and contact ≥ 39s 3 ≥ 39s Duration (use abbreviation) modified MEWS time (hours) details Temperature 38s 1 38s o / / ( C) 37s 37s 0 : mark Temp with X 36s 36s 35s 1 35s WOMEN WHOUSE NOT REQUIRE OBSERVATIONS. FOR THIS REPEATED ROUTINE CHART INTRAPARTUM FOR PREGNANT/POSTNATAL USE MATERNITY VITAL SIGNS CHART SIGNS VITAL MATERNITY write value if off scale Reason: ≤ 34s 3 ≤ 34s / / Level of Normal 0 Normal Consciousness : mark LOC with X Abnormal 3 Abnormal Reason: MATERNITY EARLY WARNING SCORE TOTAL MEWS TOTAL or apply exemption (EX) or EX / / Pain score Rest Rest : (0-10) Movement Movement Initials Reason: