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RSUP SANGLAH DENPASAR RM.4.4//ASS.

RJ/2015
Nama :

EARLY WARNING OBSERVATION SCORE CHART Tgl.Lahir : L/P


OBSTETRICS
No RM :

Tgl : Jam : Ruangan :


Skor 0 1 2 3
Sp O2 (%) >95 90-94 88-89 <88
Urine Output (ml/jam) <50ml/2jam <100ml/4jam <10ml/jam
Kesadaran Alert Voice Confused/Agitated Unconsious/Pain :PU
Tanpa kateter 8 jam tanpa produksi urin & kandung kemih kosong 10 jam tanpa produksi urin
Tanggal
Waktu
39,5 3
39 3
38,5 3
1
38
37,5
37
36
1
35
3
Sub Score
3
210 3
200 2
190 2
180 2
170 2
160 2
150
1
140
130
120
110
100
90 1
80 3
70
3
60
3
50 3
40 3
30 3
Sistolik Sub Score
Diastolik Sub Score
130 3
120 2
2
110
1
105
100
90
80
75 1
70
1
60
2
50 2
40 3
Sub score
3
35 3
30
2
25
1
20
15
1
10
2
5
3
Sub score
Urine Score
CNS score
SpO2 (%)
Total EWOSCO
Adopted from EWS Royal College of Physicians , United Kingdom, Modified by Maternal Fetal Medicine Division of Obstetrics and Gynecology Department of Medical Faculty Udayana University/Sanglah Hospital
EWOSCO 3= resiko deteriorasi kecil, EWOSCO 4-5=Kriteria deteriorasi sedang, EWOSCO 6= Kriteria deteriorasi Berat

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