Mainz Emergency Evaluation Score
The Mainz Emergency Evaluation Score ( MEES ) is a scoring system for classifying the severity of traumatized patients in order to document and sustainably improve the effectiveness of the preclinical care of patients by the emergency services . It was published in 1992 by Hennes and co-workers.
construction
The Rapid Acute Physiology Score (RAPS), which is common in the German-speaking area and is comparable to the Rapid Acute Physiology Score (RAPS) used primarily in the Anglo-American area, is based on several different parameters (see below) and is recorded at the beginning of treatment and when handing over to the emergency room .
In addition to the Glasgow Coma Scale (GCS), the MEES also takes into account vital parameters such as blood pressure , oxygen saturation and heart rate .
From the total of seven examined vital parameters, each with a maximum of 4 points (= physiological condition) and at least 1 point (= life-threatening condition), the result is a maximum score of 28, a minimum score of 7 points.
If only a single parameter has been rated with a 1, the entire score is provided with an * in order not to falsify the life-threatening situation with a high score.
The two values thus obtained (MEES 1 (arrival of the emergency doctor ) and MEES 2 (handover)) are subtracted from one another at the end and the value ΔMEES is determined.
The following applies:
- ΔMEES ≥ +2 - improvement of the patient's condition
- ΔMEES 0 ± 1 - no demonstrable change
- ΔMEES ≤ −2 - deterioration of the patient's condition
Review at a glance
| parameter | rating | Value limits for adults | Small child value limits |
|---|---|---|---|
| GCS | 4th | 15th | 15-13 |
| 3 | 14-12 | 12-11 | |
| 2 | 11-8 | 10-8 | |
| 1 | ≤ 7 | ≤ 7 | |
| Heart rate | 4th | 60-100 | ≥ 111 |
| 3 | 50-59; 101-130 | 110-90 | |
| 2 | 40-49; 131-160 | 89-60 | |
| 1 | ≤ 39; ≥ 160 | ≤ 59 | |
| Respiratory rate | 4th | 12-18 | undisturbed spontaneous breathing |
| 3 | 8-11; 19-24 | Nostrils | |
| 2 | 5-7; 25-30 | Recoveries / Stridor | |
| 1 | ≤ 4; ≥ 31 | Gasping / apnea | |
| Heart rhythm | 4th | Sinus rhythm | |
| 3 | SVES , VESmono | ||
| 2 | Arrhythmia absoluta , VESpoly | ||
| 1 | Ventricular tachycardia , ventricular fibrillation , asystole | ||
| pain | 4th | no pain | |
| 3 | slight pain | ||
| 2 | severe pain | ||
| not applicable | not applicable | ||
| Blood pressure (mm / Hg) | 4th | 120/80 - 140/90 | strong radial or brachial pulse |
| 3 | 100/70 - 119/79; 141/91 - 159/94 | just palpable radial pulse | |
| 2 | 80/60 - 99/69; 160/95 - 229/119 | strong carotid or femoral pulse | |
| 1 | ≤ 79/59; ≥ 230/120 | Just palpable or absent carotid or femoral pulse | |
| SpO 2 (%) | 4th | 100-96 | |
| 3 | 95-91 | ||
| 2 | 90-86 | ||
| 1 | ≤ 85 | ||
| Sum (= MEES value) | |||
discussion
The scope of the table alone makes it clear that the MEES is relatively time-consuming and should ideally be collected after an operation and not in parallel. All relevant values are recorded by default in a deployment log, so that the number of points can also be determined later.
The primary purpose of the scale is not to assess a patient's status, but rather the work of the emergency services personnel. Therefore, a subsequent evaluation makes perfect sense , especially with regard to quality assurance and improvement.
By including further physiological variables, the MEES developed for trauma patients can be used for all emergency patients.
literature
- Th. Reinhardt, H.-J. Hennes: Mainz Emergency Evaluation Score (MEES) Adaptation to the DIVI emergency doctor protocol, version 4.0. Emergency and Rescue Medicine 1999; 2: 380-381
- A. Albrecht, Th. Schlechtriemen, K.-H. Altemmeyer: MEES in childhood. Proposal to modify the MEES for use in children. Emergency and Rescue Medicine 1999; 2: 436-441.
- Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 468 f.