MARSI-MEWS is an early warning score for evaluating an inpatient with anorexia nervosa. This was developed out of MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa).
Patient selection: inpatient with anorexia nervosa
Parameters:
(1) systolic blood pressure in mm Hg
(2) respiratory rate in breaths per minute
(3) postural drop in blood pressure in mm Hg
(4) pulse rate in beats per minute
(5) body temperature in °C
|
Parameter |
Finding |
Points |
|
systolic blood pressure |
< 80 mm Hg |
3 |
|
|
80 to 89 mm Hg |
2 |
|
|
90 to 140 mm Hg |
0 |
|
|
141 to 150 mm Hg |
1 |
|
|
151 to 160 mm Hg |
2 |
|
|
> 160 mm Hg |
3 |
|
respiratory rate |
<10 bpm |
3 |
|
|
10 to 20 bpm |
0 |
|
|
21 to 30 bpm |
2 |
|
|
> 30 bpm |
3 |
|
postural drop in blood pressure |
<= 10 mm Hg |
0 |
|
|
11 to 20 mm Hg |
1 |
|
|
21 to 30 mm Hg |
2 |
|
|
> 30 mm Hg |
3 |
|
pulse rate |
< 40 bpm |
3 |
|
|
40 to 49 bpm |
1 |
|
|
50 to 90 bpm |
0 |
|
|
91 to 100 bpm |
1 |
|
|
101 to 110 bpm |
2 |
|
|
> 110 bpm |
3 |
|
temperature |
< 35 °C |
3 |
|
|
35 to 35.9 °C |
2 |
|
|
36 to 37 °C |
0 |
|
|
37.1 to 38 °C |
1 |
|
|
38.1 to 39 °C |
2 |
|
|
> 39 °C |
3 |
total score = SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
|
Total Score |
Monitor |
Clinician Assessment |
|
0 |
monitor normally |
|
|
1 or 2 |
monitor every 4 hours |
|
|
3 or 4 |
monitor hourly |
within 30 minutes |
|
5 |
monitor every 30 minutes |
immediately |
|
>= 6 |
close |
contact consultant |
Other things to monitor:
(1) AVPU (alert, respond to verbal, respond to pain, unresponsive): respond if NOT alert
(2) blood glucose: respond to reading less than 4 mmol/L
Specialty: Psychiatry
