Implementing a paediatric early warning score into pre-hospital practice

Area of Science:

• Pediatric Emergency Medicine
• Pre-hospital Care
• Clinical Assessment Tools

Background:

• Ambulance clinicians require enhanced education for assessing unwell children.
• A validated Paediatric Early Warning Score (PEWS) was explored for pre-hospital use.

Purpose of the Study:

• To evaluate the safety and effectiveness of the Paediatric Observations Priority Score (POPS) in pre-hospital pediatric care.
• To assess improvements in ambulance clinicians' confidence and competence in examining unwell children.

Main Methods:

• A validated PEWS, the POPS, was implemented in pre-hospital practice.
• Clinician confidence and competence were surveyed before and after the trial.
• Interrater reliability of the POPS was calculated using patient report forms.

Main Results:

• Interrater reliability for POPS was found to be moderate (Kappa coefficient = 0.401).
• Clinician self-reported confidence and competence significantly improved across all assessed pediatric patient presentations.
• POPS demonstrated reliability in scoring, with decreased variance as scores increased.

Conclusions:

• The POPS is a safe and effective tool for ambulance clinicians assessing unwell children.
• Implementation of POPS led to enhanced self-reported confidence and competence among pre-hospital clinicians.
• POPS aids in identifying critically unwell children and those suitable for discharge.