Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

A proposed Primary Health Early Warning Score (PHEWS) with emphasis on early detection of sepsis in the elderly

Ian Anderson
+ Author Affiliations
- Author Affiliations

Correspondence to: Dr Ian Anderson Waiuku Medical Centre, 30 Constable Rd, Waiuku 2123, New Zealand. Email: iancarol@ps.gen.nz

Journal of Primary Health Care 8(1) 5-8 https://doi.org/10.1071/HC15044
Published: 31 March 2016

Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

There are several secondary care early warning scores which alert for severe illness including sepsis. None are specifically adjusted for primary care. A Primary Health Early Warning Score (PHEWS) is proposed which incorporates practical parameters from both secondary and primary care.

KEYWORDS:Emergency medical services; acute care; sepsis; early intervention


References

[1]  Royal College of Physicians. National Early Warning Score (NEWS): Standardising the assessment of acute-illness severity in the NHS. Report of a working party. London: RCP, 2012.

[2]  Robb G, Seddon M. A multi-faceted approach to the physiologically unstable patient. Qual Saf Health Care 2010; 19 1–6.

[3]  SIRS. sepsis, and septic shock criteria. Available at: http://www.mdcalc.com/sirs-sepsis-and-septic-shock-criteria/. [Cited November 2015.]

[4]  Ewig S, Welte T. CRB-65 for the assessment of pneumonia severity: who could ask for more? Thorax 2008; 63 665–6.
CRB-65 for the assessment of pneumonia severity: who could ask for more?Crossref | GoogleScholarGoogle Scholar | 18663064PubMed |

[5]  The UK Sepsis Trust. Primary Care Toolkit: General Practice management of Sepsis, 2014. Available at: http://sepsistrust.org/wp-content/uploads/2015/08/1409322498GPtoolkit2014.pdf. [Cited November 2015.]

[6]  Mercer SW, Howie JG. CQI-2 a new measure of holistic interpersonal care in primary care consultations. Br J Gen Pract 2006; 56 262–8.
| 16611514PubMed |

[7]  Corfield AR, Lees F, Zealley I, Houston G, Dickie S, et al. Utility of a single early warning score in patients with sepsis in the emergency department. Emerg Med J 2014; 31 482–7.
Utility of a single early warning score in patients with sepsis in the emergency department.Crossref | GoogleScholarGoogle Scholar | 23475607PubMed |

[8]  Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med 2006; 34 15–21.
The effect of age on the development and outcome of adult sepsis.Crossref | GoogleScholarGoogle Scholar | 16374151PubMed |

[9]  Castle SC. Clinical relevance of age-related immune dysfunction. Clin Infect Dis 2000; 31 578–85.
Clinical relevance of age-related immune dysfunction.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3cXnsVKqu7w%3D&md5=cc851fb3f9718eec7f1c976c1eafdfbbCAS | 10987724PubMed |

[10]  Salive ME. Multimorbidity in Older Adults. Epidemiol Rev 2013; 35 75–83.
Multimorbidity in Older Adults.Crossref | GoogleScholarGoogle Scholar | 23372025PubMed |

[11]  Dwyer R, Hedlund J, Henriques-Normark B, Kalin M. Improvement of CRB-65 as a prognostic tool in adult patients with community-acquired pneumonia. BMJ Open Respir Res 2014; 1 e000038
Improvement of CRB-65 as a prognostic tool in adult patients with community-acquired pneumonia.Crossref | GoogleScholarGoogle Scholar | 25478185PubMed |

[12]  Challen K, Bright J, Bentley A, Walter D. Physiological-social score (PMEWS) vs CURB-65 to triage pandemic influenza: a comparative validation study using community-acquired pneumonia as a proxy. BMC Health Serv Res 2007; 7 33
Physiological-social score (PMEWS) vs CURB-65 to triage pandemic influenza: a comparative validation study using community-acquired pneumonia as a proxy.Crossref | GoogleScholarGoogle Scholar | 17328822PubMed |

[13]  Guerin JM, Meyer P, Habib Y. Severe diarrhoea in pneumococcal bacteraemia. JAMA 1987; 257 1897–8.
Severe diarrhoea in pneumococcal bacteraemia.Crossref | GoogleScholarGoogle Scholar |

[14]  Reisinger EC, Fritzsche C, Kraus R, Krejs GJ. Diarrhoea caused by primarily non-gastrointestinal infections. Nat Clin Pract Gastroenterol Hepatol 2005; 2 216–22.
Diarrhoea caused by primarily non-gastrointestinal infections.Crossref | GoogleScholarGoogle Scholar | 16265204PubMed |

[15]  Nasa P, Juneja D, Singh O. Severe sepsis and septic shock in the elderly: An overview. World J Crit Care Med 2012; 1 23–30.
Severe sepsis and septic shock in the elderly: An overview.Crossref | GoogleScholarGoogle Scholar | 24701398PubMed |