Paediatric early warning systems (PEWS) in the ED

Paediatric early warning scores are predictors of adverse outcome in the pre-hospital setting: A national cohort study

“…(19,25) Using a PEWS in a group of patients or environment for which they were not designed can also cause issues with trade off of sensitivity and specificity. (19,33,34) As such each PEWS system has a recommended score to escalate care within that environment, with the assumption that specificity increases with increasing score.…”

“…Studies in ED suggest PEWS may be better at identifying medically unwell patients than surgically unwell/trauma, (19,34) and that therefore suggests that PEWS (Scotland) can support, but not replace, triage. (33,35) All teaching on PEWS (Scotland) in hospital settings reiterates the importance of "staff or carer concerns" which are seen to "trump" a low score when present and contribute to the in-hospital PEWS (Scotland) system. As this study population is an unselected group transferred by ambulance it is likely that parent/ carer concern will be high, however it may be that the sensitivity of the score could be enhanced by the tacit knowledge input of the paramedic crew.…”

Evaluation of COVID-19 assessment in emergency departments and ambulance services

“… PMEWS [8]  The Swine Flu Hospital Pathway [9]  NEWS2 [10]  The WHO decision-making algorithm for hospitalisation with pneumonia [11]  POPS [12]  COAST [13] The triage tools will be retrospectively applied to the data by the study statisticians. CURB-65 and PMEWS will be evaluated in adults only, NEWS2 will be evaluated in adults excluding pregnant women, POPS will be evaluated in children only.…”

Do paediatric early warning systems reduce mortality and critical deterioration events among children? A systematic review and meta-analysis

“… 1 Published PEWS use a constellation of physiological criteria (including vital signs), clinical assessment findings, pre-existing medical conditions, and clinician or parental concerns. 2. , 3.…”