Background Early warning scores compliment clinical decision making and can identify trends depicting deterioration in patient’s condition. Age appropriate Burton Paediatric Early Warning System (BPEWS) score charts were developed in 2011 using nine indicators which included physiological parameters, therapeutic intervention and doctor/nurse concern.

Aim To assess the usefulness of BPEWS as a reliable and valid indicator for all children in need of urgent medical assessment and intervention.

Methods A retrospective analysis of all children transferred to paediatric intensive care setting over the preceding 12 months was carried out to validate BPEWS charts. Detailed case notes review was undertaken to evaluate if BPEWS could have been useful to alert us of patients’ deterioration in the 24 hour period prior to transfer. Each case note was assessed by two reviewers.

Results An average of 8.7 sets of observations per patient was recorded in the 24 hours period prior to intensive care transfer. Off the 200 sets of observations recorded in 23 patients, 93% sets would have triggered based on BPEWS. 44% sets of observation scores were in amber (4–7) while 35% were in red (>7) category. Average highest BPEWS score was 9.5 (range: 4–19). In 43% and 57% of patients, highest BPEWS score fell in amber and red category respectively.

Conclusions BPEWS score charts are effective in identifying children at risk of sudden deterioration. Timely identification is likely to enable early action to reduce the risk of death or serious morbidity thus improving the outcome of care given to hospitalised children.