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Scoping Review of Pediatric Early Warning Systems (PEWS) in Resource-Limited and Humanitarian Settings

Stephanie R Brown1, Daniel Martinez Garcia2, Asya Agulnik3

  • 1Seattle Children's Hospital, University of Washington, Seattle, WA, United States.

Frontiers in Pediatrics
|January 24, 2019
PubMed

Insights

Pediatric Early Warning Systems (PEWS) can improve care for hospitalized children in resource-limited settings (RLS). While evidence is limited, some studies show PEWS reduces deterioration and mortality, highlighting the need for more research.

Area of Science:

  • Pediatric critical care
  • Health systems research
  • Global child health

Background:

  • Pediatric Early Warning Systems (PEWS) are designed to detect deterioration in hospitalized children using vital signs and clinical status.
  • PEWS, when combined with quality improvement, is effective in high-resource settings and shows potential for resource-limited settings (RLS).

Purpose of the Study:

  • To review existing evidence on the use of PEWS in RLS.
  • To identify gaps in research regarding PEWS implementation in RLS.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (Web of Science, PubMed, Scopus, CINAHL, EMBASE, BVS, TRIP).
  • Studies focusing on PEWS or PEWS scores in pediatric populations in low- and middle-income countries were included.

Main Results:

  • Limited research exists, with eight studies identified.
  • Two studies demonstrated clinical benefits: one reported reduced clinical deterioration, and another showed reduced mortality.
  • Other studies explored the association between PEWS scores and adverse outcomes without a response algorithm.

Conclusions:

  • Further research is essential to understand the impact of PEWS implementation on inpatient pediatric care and outcomes in RLS.
  • The potential of PEWS to enhance child healthcare in resource-limited environments warrants continued investigation.

Keywords:
hospital mortalityhumanitarian pediatricspediatric early warning systemquality of careresource-limited settings

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