Critical illness is a substantial burden in developing countries. Reliable epidemiological data on critical illness in low resource settings are scarce. Critically ill patients are often cared in the wards due to lack of intensive care unit (ICU) beds. It was shown that physiological changes (early warning signs) start as early as 8 hours prior to an event like cardiac arrest or death. There are very few evidence – based studies on early recognition of such warning signs. Intermediate Medical care unit (IMC) is a step – down unit in between acute care and general ward care. Implementation of National Early Warning score (NEWS) in patients admitted in Intermediate Medical Care enable us to recognize patients with moderate scores and act at the right time by shifting them to ICUs and to prevent worsening of their condition.