Observation Chart for

Patient Name: Hospital Number:
Date ()
Time 17.50 19.00 20.00 20.05 20.15

Blood pressure mmHg

<-------------->

Pulse per minute ()

  • >160
  • 160
  • 150
  • 140
  • 130
  • 120
  • 110
  • 100
  • 90
  • 80
  • 70
  • 60
  • 50
  • 40
↑
¦
¦ ↑ ↑
↑ ¦ ¦ ¦
¦ ¦ ¦ 64
¦ ↓ ¦ ¦
¦ ↓ ¦
↓ ↓
Temperature 38.4 38.0 38.1 38.1
CVP/GCS P V V V P
RR (per min) 25 24 24 27 26
Oxygen Sats (%) 99 99 99 99 98
Oxygen delivery % / Litres 15 L 15 L 15 L 15 L 15 L
O2 device on air (A) NRM NRM NRM NRM NRM
Blood sugar (mmols) 11.5
EWS Score Individual scores for each observation and total score | Check against EWS criteria
Temp 2 0 2 2
Systolic BP 3 0 2 2 3
HR 2 2 2 1 2
RR 2 2 2 2 2
Oxygen % 3 3 3 3 3
Neuro (AVPU) 2 1 1 1 2
Urine 0 0 0 0 0
Total EWS Score 14 8 10 11 14
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