Feasibility and Reliability of Pediatric Early Warning Score in the Emergency Department

Abstract

Pediatric early warning scores in an emergency department may be used in routine patient evaluation of illness severity and resource allocation, thereby positively impacting quality and safety in pediatric care. This prospective nursing study assessed the feasibility and reliability of pediatric early warning scores in a busy, inner-city, level 1 trauma center pediatric emergency department. The pediatric early warning scores demonstrated high interrater reliability (degree of agreement among scorers) (intraclass correlation coefficient = 0.91) and intrarater reliability (multiple repetitions by a single scorer) (intraclass correlation coefficient = 0.90).

Desenvolvimento e validação de conteúdo do Escore Pediátrico de Alerta

“…Alguns estudos sugerem um papel potencial dos PEWS na identificação precoce da sepse, sendo atrelados a um algoritmo padrão de sepse em alguns hospitais pediátricos, funcionando como ramo aferente para acionar equipes de resposta rápida. (26) O tempo de enchimento capilar refere-se a contagem dos segundos necessários para que uma determinada área seja reperfundida após 5 segundos de pressão local. Um TEC > 2 segundos indica má perfusão tecidual, podendo-se suspeitar de desidratação, choque ou hipotermia.…”

The accuracy of the pediatric assessment triangle in assessing triage of critically ill patients in emergency pediatric department

“…It is convenient to use and easy to operate, with a total score of 0-9. Previous studies have shown that PEWS score 3 is the best cut-off for predicting critically ill children, indicating the trend of deterioration of the condition and that the patient can be transferred to intensive care unit [17,25,26]. PEWS, as a regular tool in EPD in China, was taken as a tool for comparison in this study.…”

Association of out of hospital paediatric early warning score with need for hospital admission in a Scottish emergency ambulance population

“…Generally studies found that increasing the cut off for PEWS score increased sensitivity for admission but decreased specificity, as shown in table one. One study found that a PEWS ≥3 resulted in an odds ratio of admission 4.1 p<0.001 [12] , with a separate study reporting that a single point increase in PEWS increased the odds of admission 54% relative to the odds of discharge (odds ratio 1.54; 95% CI, 1.32-1.81) [17] . An evaluation of ten different PEWS in the ED found an AUROC for hospital admission ranging between 0.56 (95% CI 0.55-0.62) and 0.68 (95% CI 0.66-0.69) for the scores [10] .…”