The Cardiovascular
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Pediatric Early Warning Score (PEWS)

Flags hospitalised children at risk of clinical deterioration.

Pediatric Early Warning Score (PEWS)
Behaviour
Cardiovascular
Respiratory
Continuous nebuliser therapy or persistent post-operative vomiting
Result0 points

Low score: routine observation.

When to use

  • Structured bedside surveillance of hospitalised children to identify early clinical deterioration and trigger escalation of care.

Formula

Sum of Behaviour (0-3), Cardiovascular (0-3), and Respiratory (0-3) domains, plus 2 points if the child requires continuous nebulised therapy or has persistent post-operative vomiting.

Pearls and pitfalls

  • Age-specific normal heart-rate and respiratory-rate ranges are needed to score the cardiovascular and respiratory domains.
  • Local escalation thresholds vary; many programmes call for urgent review at a total score of 5 or the presence of any single domain score of 3.

References

  1. Monaghan A. Detecting and managing deterioration in children. Paediatric Nursing. 2005;17(1):32-35.