Republished: Paediatric early warning scores: Holy Grail and Achilles' heel

Abstract

Early Warning Scores (EWS) have become increasingly used by hospitals throughout the world to prevent unexpected admission to intensive care or even death in their inpatient population. It is well known that signs of deterioration are present well before collapse and by a combination of systems, EWS enable healthcare professionals to intervene at an appropriate time. A number of national bodies and regulators in the UK have required the use of Early Warning Scores in locations where children are inpatients. This article attempts to describe the background to their development, identify common problems and provide information for units interested in introducing an EWS into their department.

Paediatric early warning systems: not a simple answer to a complex question

“…These have been delivered by the use of early warning systems (EWS) to aid recognition and response to patient deterioration 2 which have included: 1. The development of track and trigger tools 3 (numerical values assigned to commonly measured physiological and observation values which produce a composite score that correlates to an escalating response process dependant on the score) 2. Rapid response teams (RRTs) 4 (experienced staff assigned to respond to patients who trigger criteria predictive of impending need for intensive care) and 3.…”

“…The development of track and trigger tools3 (numerical values assigned to commonly measured physiological and observation values which produce a composite score that correlates to an escalating response process dependant on the score)…”