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Use of the modified early warning score in emergency medical units

Imogen A Mitchell, Mary-Ann Kulh and Heather McKay
Med J Aust 2011; 195 (8): . || doi: 10.5694/mja11.10995
Published online: 17 October 2011

To the Editor: Since 2008, the Australian Capital Territory’s public acute health care system has successfully been using multiple-parameter and single-parameter track, trigger and response (TTR) systems in parallel for the recognition of and response to clinical deterioration in patients. Jenkins and colleagues correctly identify that there is a general lack of agreement on the use of TTR systems around Australia, although they note that the most commonly used rapid response system is the medical emergency team (MET) alert which is triggered by a single parameter, a vital sign derangement, or a concern for the patient.1 As Jenkins et al suggest, a multiple-parameter TTR system may trigger a response earlier than might occur with MET parameters.


  • 1 Canberra Hospital, Canberra, ACT.
  • 2 Health Directorate, Australian Capital Territory Government, Canberra, ACT.


Correspondence: Imogen.mitchell@act.gov.au

Competing interests:

No relevant disclosures.

  • 1. Jenkins PF, Thompson CH, Barton LL. Clinical deterioration in the condition of patients with acute medical illness in Australian hospitals: improving detection and response. Med J Aust 2011; 194: 596-598. <MJA full text>
  • 2. Mitchell IA, McKay H, Van Leuvan C, et al. A prospective controlled trial of the effect of a multi-faceted intervention on early recognition and intervention in deteriorating hospital patients. Resuscitation 2010; 81: 658-666.
  • 3. Morgan RJM, Williams F, Wright MM. An early warning scoring system for detecting critical illness. Clin Intensive Care 1997; 8: 1388-1392.
  • 4. Compass. Early Recognition of the Deteriorating Patient Program. Canberra: ACT Health, 2007. http://www.health.act.gov.au/c/health?a=da&did=11025490 (accessed Jun 2010).

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