Related Experiment Video
Updated: Sep 22, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
The application of pediatric early warning score (PEWS) in emergency observation room
Ye Cheng1, Xiaolei Zhang1, Jiayan Zhang1
1Department of Pediatric Emergency Medicine and Critical Care Medicine, Children's Hospital of Fudan University, Shanghai 201102, PR China.
Insights
The Pediatric Early Warning Scoring system (PEWS) effectively identifies critically ill children in China. Its discharge value demonstrates the strongest predictive ability for PICU admission and mortality.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Assessment Tools
- Critical Care Pediatrics
Background:
- Early identification of critically ill children is crucial in emergency settings.
- Pediatric Early Warning Scores (PEWS) are designed to standardize the assessment of pediatric patients at risk of deterioration.
- The utility of PEWS in emergency observation rooms, particularly in China, requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of the Pediatric Early Warning Scoring system (PEWS) in an emergency observation room in China.
- To determine the predictive value of different PEWS time-points (admission, highest, discharge) for critical outcomes.
Main Methods:
- A retrospective study included 4717 children admitted to an emergency observation room between January 2019 and August 2020.
- The Brighton Pediatric Early Warning Score (PEWS) was assessed at admission, at its highest point, and at discharge.
- Statistical analysis, including AUROC curves, was used to compare PEWS values across different outcome groups (discharge, specialized ward, ICU) and predict PICU admission/mortality.
Main Results:
- Significant differences in admission, highest, and discharge PEWS values were observed among the three groups (P<0.001).
- The highest PEWS values were significantly lower in the discharged and specialized ward groups compared to the ICU group (P<0.001).
- The discharge PEWS value exhibited the strongest predictive ability for PICU admission (AUROC 0.974) and mortality (AUROC 0.951), with specific cutoff values identified.
Conclusions:
- The Pediatric Early Warning Scoring system (PEWS) is valuable for the early identification and warning of critically ill children in emergency observation settings.
- The discharge PEWS value is a particularly strong predictor of critical outcomes, including PICU admission and mortality.
- PEWS implementation in Chinese emergency observation rooms can aid in timely clinical intervention and resource allocation.
Objective:
To explore the value of pediatric early warning scoring system (PEWS) in an emergency observation room in China.
Methods:
The children who had been admitted consecutively to the emergency observation room from Jan, 2019 to Aug, 2020 were selected. Three most important time-points including the first value (admission value), the highest value during the observation (highest value), and final value (discharge value) of Brighton Pediatric Early Warning Score (PEWS) was evaluated in all patients.
Results:
4717 patients were included. They were categorized into 3 groups, namely, discharged group (G1, n = 2320), specialized ward group (G2, n = 2128), and ICU group (G3, n = 269). The different PEWS values of admission value, highest value, and discharge value were significantly different among the 3 groups (P<0.001). Highest value of G1 and G2 were significantly lower than that of G3 (P<0.001). AUROC curves of different PEWS values were used to predict the possibility of PICU admission and PICU mortality within 24 h of admission, and the values were 0.698, 0.878, 0.974 and 0.709, 0.883, 0.951, respectively. The cutoff values for PICU admission of 3 different PEWS values were 2.5 (sensitivity 0.635, specificity 0.699), 3.5 (sensitivity 0.817, specificity 0.9), 3.5 (sensitivity 0.837, specificity 0.985). The cutoff values for PICU mortality of 3 different PEWS values were 4 (sensitivity 0.625, specificity 0.799), 4.5 (sensitivity 0.722, specificity 0.79), 4.5 (sensitivity 0.883, specificity 0.987). The discharge value had the strongest prediction ability.
Conclusions:
PEWS can be used for early identification and warning of critically ill children.
Related Concept Videos
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:23Cardiopulmonary Resuscitation III: AED Use
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...