Rethinking early warning scores

Dr Stephanie Heys, Susan Rhind, Camella Main and Daisy Pegler discuss misplaced metrics when caring for pregnant and recently pregnant women in pre-hospital care. Despite escalating global concern around the high rates of morbidity and mortality in pregnant patients, the early signs of clinical deterioration in pregnant patients often go unrecognised, particularly in the pre-hospital environment (Ebert et al, 2020; McCullough et al, 2024). A critical, yet underappreciated, contributing factor is the application of generic early warning scores, such as the National Early Warning Score 2 (NEWS2). The NEWS2 has been applied with a blanket approach in the pre‑hospital setting without considering groups of patients where they are not validated, such as pregnancy and immediately following pregnancy.