DRAFT

Date
Time
Respiratory
Rate
(breaths / min)

O2 Saturation
(%)

O2 Flow Rate
(L / min)

Blood
Pressure

DO NOT WRITE IN THIS BINDING MARGIN

(mmHg)

If systolic BP 200, write
value in box

Heart Rate
(beats / min)

If heart rate 140, write
value in box

Temperature
(C)

Consciousness

If necessary, wake patient
before scoring

4 Hour Urine Output
(mL)

Pain Score
  None (0) – Worst (10)

09/2010

ADDS
Scores

6/3/2013

20:00

37
36
31–35
21–30
9–20
5–8
4
93
90–92
85–89
84
>5
1–5
<1
Write 200
190s
180s
170s
160s
150s
140s
130s
120s
110s
100s
90s
80s
70s
60s
50s
40s
Write 140
130s
120s
110s
100s
90s
80s
70s
60s
50s
40s
30s
38.6
38.0–38.5
36.1–37.9
35.1–36.0
34.1–35.0
34.0
Alert
To Voice
To Pain
Unresp.
800
120–799
80–119
79
Write

Respiratory Rate
O2 Saturation
O2 Flow Rate
Systolic BP
Heart Rate
Temperature
4 Hour Urine Output
Consciousness
TOTAL ADDS

I Interventiont

E.g. ‘A’

250

37
36
31–35
21–30
9–20
5–8
4
93
90–92
85–89
84
>5
1–5
<1
Write 200
190s
180s
170s
160s
150s
140s
130s
120s
110s
100s
90s
80s
70s
60s
50s
40s
Write 140
130s
120s
110s
100s
90s
80s
70s
60s
50s
40s
30s
38.6
38.0–38.5
36.1–37.9
35.1–36.0
34.1–35.0
34.0
Alert
To Voice
To Pain
Unresp.
800
120–799
80–119
79

1
0
1
1
1
0
0
0
4

DRAFT - NOT
FOR USE

URN:
Family Name: Barber

Modifications in use

Family name:
Given Name: Frederick
Given names:
Date of Birth: 2/3/1931
Date of birth: Sex:

x

M

If any observation is in a shaded area, add up the Total ADDS Score and take the
action required for that score.

Score 0
Score 1
Score 2
Score 3
Emergency call

Actions Required
Total ADDS Score 1–3

Total ADDS Score 4–5




Record observations at least once
every 4 hours
Carry out appropriate interventions
as prescribed
Manage fever, pain or distress
Review O2 delivery
Consider informing Team Leader




Ward doctor to review patient within
30 minutes
Request review, and note on the
back of this form
Notify Team Leader
Record observations at least once
every 30 minutes
If patient must leave ward area,
Nurse must accompany patient

Total ADDS Score 6–7

Total ADDS Score





Registrar to review patient within 30
minutes
Request review, and note on the
back of this form
Registrar to ensure consultant is
notified
Ward doctor to attend
If patient must leave ward area,
Intern and Nurse must accompany
patient



8

Consider Emergency call
Registrar to review patient within
10 minutes
Request review, and note on the
back of this form
Registrar to ensure Consultant is
notified
If patient must leave ward
area, Registrar and Nurse must
accompany patient

Emergency call if:
ADDS
Scores

E.g. ‘A’

F

Adult Deterioration Detection System (ADDS)

Write

4
1
0
1
1
1
1
0
0
5

(Affix patient identification label here)
MRN: 0598371

20:30







Any observation is in a purple area
Airway threat
Respiratory or cardiac arrest
New drop in O2 saturation < 90%
Sudden fall in level of consciousness
Seizure
You are seriously worried about the patient but they do not fit the above criteria

Modifications must be reviewed at least every 72 hours.If the patient is deteriorating or an observation is in a shaded area -.At a frequency appropriate for the patient’s clinical state. record here and note letter in Intervention row over page in appropriate time column.NOT FOR USE MRN: 0598371(Affix patient identification label here) (Affix patient identification label here) Adult Deterioration Detection System (ADDS) Chart MRN: 0598371 URN: Family Name: Barber Family name: Given Name: Frederick Datenames: of Birth: 2/3/1931 Given Date of birth: Sex: Facility: x M URN: Name: Barber Family Family name: Given Name: Frederick Given names: Date of Birth: 2/3/1931 F Date of birth: Sex: Other Charts In Use Alcohol Withdrawal Insulin Infusion Anticoagulant Neurology Fluid Balance Neurovascular Pain/Epidural/Patient Controlled Analgesia Review requested Date Reason Other ADDS Review undertaken ENT Bones / Joints Management Management changed Specify: to Heart Rate to Temperature to Consciousness to 4 Hour Urine Output to Designation Doctor’s name (please print) Additional Observations Date Signature Time Blood Glucose Level (mmol / L) Date Weight Time /  / : (kg) Bowels Interventions Urinalysis Specific gravity pH Leukocytes Blood Nitrite Ketones Bilirubin Urobilinogen Protein Glucose Designation Signature DO NOT WRITE IN THIS BINDING MARGIN Systolic BP E /  / Skin ADDS CHART  O2 Flow Rate to Emergency Specify: No change. If you administer an intervention. use the symbols indicated on the chart. Doctor’s name (please print) to Respiratory Rate D : Registrar Neurology Modifications C Time Ward doctor Circulation »» Whenever an observation falls within a shaded area. A Time Airway »» You must calculate a Total ADDS Score: -. unless a modification has been made (see below). to F Clinical Reviews General Instructions O2 Saturation x M . observe If abnormal observations are to be tolerated for the patient’s clinical condition. B : Breathing »» When graphing observations. give details »» You must record appropriate observations: -. you must enter the ADDS Score for that vital sign in the appropriate row of the ADDS Scores table. Date /  / Not examined Normal Abnormal If abnormal.On admission -.NOT FOR USE DRAFT .DRAFT . For blood pressure. write the acceptable ranges (where the ADDS Score will be 0) below. place a dot (•) in the centre of the box which includes the current observation in its range of values and connect it to the previous dot with a straight line.Whenever you are concerned about the patient.