|
Overview :
The Mainz
Emergency Evaluation Score (MEES) is a dynamic scoring system for prehospital
emergency medical services. It is not intended to predict outcome but can be
used to evaluate the efficacy and quality of the prehospital
interventions.
NOTES: This
score was recommended for inclusion by Dr Martin Dehler. A modification of the
MEES to include capnometry can be used to evaluate patients who have had
cardiopulmonary resuscitation in a prehospital setting (see Chapter
6).
Parameters:
(1) Glasgow coma
scale
(2) heart
rate
(3) respiratory
rate
(4) cardiac
rhythm
(5)
pain
(6) blood
pressure
(7) oxygen
saturation
|
Degree of Change in
Parameter |
Scoring
(Below) |
|
physiologic,
normal |
4 |
|
mild
deviation |
3 |
|
considerable
deviation |
2 |
|
life-threatening |
1 |
Patient
selection: The MEES is not applicable to children.
|
Parameter |
Finding |
Points |
|
Glasgow
coma scale |
15 |
4 |
|
|
12 -
14 |
3 |
|
|
8 -
11 |
2 |
|
|
<=
7 |
1 |
|
heart rate
|
<= 39
beats per minute |
1 |
|
|
40 -
49 |
2 |
|
|
50 -
59 |
3 |
|
|
60 -
100 |
4 |
|
|
101 -
130 |
3 |
|
|
131 -
160 |
2 |
|
|
>=
161 |
1 |
|
respiratory
rate |
<= 4
breaths per minute |
1 |
|
|
5 -
7 |
2 |
|
|
8 -
11 |
3 |
|
|
12 -
18 |
4 |
|
|
19 -
24 |
3 |
|
|
25 -
30 |
2 |
|
|
>=
31 |
1 |
|
cardiac
rhythm |
sinus
rhythm |
4 |
|
|
supraventricular extrasystole
(SVES)
isolated
ventricular extrasystole |
3 |
|
|
multiple
ventricular extrasystole
ABSARRH |
2 |
|
|
ventricular
tachycardia
ventricular
fibrillation
asystole |
1 |
|
pain |
none |
4 |
|
|
mild |
3 |
|
|
strong |
2 |
|
|
entfallt
(? extreme, ? collapse) |
1 |
|
blood
pressure |
<=
79/59 |
1 |
|
|
80/60 -
99/69 |
2 |
|
|
100/70 -
119/79 |
3 |
|
|
120/80 -
140/90 |
4 |
|
|
141/91 -
159/94 |
3 |
|
|
160/95 -
229/119 |
2 |
|
|
>=
230/120 |
1 |
|
oxygen
saturation |
96 -
100% |
4 |
|
|
91 -
95% |
3 |
|
|
86 -
90% |
2 |
|
|
<=
85% |
1 |
where:
• I am not sure what ABSARRH means. It
appears to mean "absolute arrhythmia".
• I am not sure
of the translation for entfallt.
Mainz emergency
evaluation score =
= SUM(points for
the 7 parameters)
Interpretation:
• minimum score: 7 (Hennes et al 1993
state that the minimum score is 8; the lowest score for pain is 2, since pain is
not life-threatening).
• maximum score:
28
• The higher the
score, the better the patient's condition.
• If a life-threatening score is present
(1 point) for any parameter, then an "*" is added to the sum to indicate that
the condition is life-threatening.
• Scoring is performed twice - first at
the scene of the accident and again at the emergency
department.
• If the second score is >= 2 points
greater than the initial score, then the patient's condition is considered
improved. If the second is more than 2 points less than the initial score, then
the patient is considered to have deteriorated. Else (difference of -1 to +1) it
is considered unchanged.
| References: | |
Hennes HJ, Reinhardt T, Dick W.
Beurteilung des notfallpatienten mit dem Mainz Emergency Evaluation Score MEES.
Notfallmedizin.
1992; 18: 130-136.
Hennes
H-J, Reinhardt T, et al. Die praklinische effektivitat der notarztlichen
versorgung. Anaesthesist.
1993; 42: 455-461.
Himmelseher S, Pfenninger E, Strohmenger
H. Do we need trauma scoring in emergency medicine? Anaesthesist.
1994; 43: 376-384.
Schuster
H-P, Dick W. Scoresysteme in der notfallmedizin? Anaesthesist. 1994; 40:
30-35.
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