Pediatric early warning score is a standardized score assigned to a patient through assessment of various physiological, behavioral, and clinical parameters. These warning systems facilitate early detection of clinical deterioration. These scores have proven to improve multidisciplinary team work, communication, and confidence in recognizing, reporting, and making decisions about a child at risk of clinical deterioration [1,2]. Different pediatric early warning scores (PEWSs) were developed, modified, and validated in various places across the globe, with majority of contributions from developed countries [3][4][5][6][7][8][9][10][11]. There is a wide heterogeneity in PEWS used with regard to the number of parameters settings where they are applied and the outcomes measured. However, not all of them could be applied in resource restricted settings because of the need for special equipment and technical expertise. Brighton PEWS tool is a simple clinical score involving three parameters, which can be easily performed even by nurses without the need for special equipment [6].Most of the studies have implemented Brighton PEWS in pediatric inpatient units [6,7]. There is a paucity of literature regarding the implementation of PEWS in pediatric ED; especially, in the Indian population. In resource-limited settings where specialists may not be available, registered medical practitioners or nursing personnel may be the first personnel to encounter pediatric patients. Availability of simple and validated clinical tool becomes crucial to identify the children at risk of deterioration in such settings. Hence, this study was designed to assess the validity of Brighton's PEWS tool in predicting clinical deterioration in children admitted from emergency departments (EDs) and to assess the interobserver agreement between nurses administered PEWS and pediatric trainee administered PEWS.
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