Pediatric Early Warning Score

A Pediatric Early Warning Score (PEWS) is a structured bedside tool that turns observations a nurse can see, hear and measure into a shared signal that a hospitalized child may be getting worse. It is a family of tools rather than one test: more than 30 PEWS variants are in use worldwide, each with its own scoring method and thresholds. Some are scoring-based and combine physiological measurements and clinical observations into a single composite score. Others are parameter-based and trigger an alert when any single measure exceeds a predefined limit. Published tools draw on vital signs, clinical assessment findings, and staff or parental concern. The Brighton PEWS scores behaviour, respiratory effort and cardiovascular status, among other items. The Bedside PEWS, developed at the Hospital for Sick Children in Toronto, has seven items: heart rate, systolic blood pressure, capillary refill time, respiratory rate, respiratory effort, transcutaneous oxygen saturation and oxygen therapy. Its total ranges from 0 to 26. Because the items differ from tool to tool, the RN scores the child on the chart the facility has adopted and does not...