Article Text

G295(P) Normal observations, safe discharge?
  1. M Clark1,
  2. T Harris1,
  3. A Parik1,
  4. J Pott1,
  5. D Rolland2
  1. Emergency Department, Royal London Hospital, London, UK
  2. Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Royal Infirmary, Leicester, UK


Aims Clinicians working in emergency departments use ‘normal observations’ as part of the decision making process when discharging children home. This study examined whether Paediatric Early Warning Scores (PEWS) predict unsafe discharge from the emergency department. Unsafe discharge was defined as a child returns within 7 day with the same condition and requires admission to hospital.

Methods Data was prospectively collected during the routine treatment at Royal London Hospital (n=6122). We tested whether a threshold of 0, 1, 2 or 3 predicted a safe discharge from the emergency department.

Results Unsafe discharge rates:

Abstract G295(P) Table 1

Prediction of unsafe discharge:

Abstract G295(P) Table 2

Conclusion Higher PEWS are associated with an increased rate of unsafe discharges. More importantly, 20% of unsafe discharges had normal observations. Therefore, ‘normal obs’ may not predict a safe discharge.

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.