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1565 Use of the Modified Brighton Pediatric Early Warning Score (PEWS) in a Norwegian Department for Children and Adolescents
  1. EH Eggen,
  2. A Solevåg,
  3. J Schrøder,
  4. B Nakstad
  1. Dept. of Pediatrics, Akershus University Hospital, Lørenskog, Norway

Abstract

Background and Aims Structured observations and examination are crucial. However, paediatric early warning scoring systems is a relatively new concept.

We aimed to investigate the feasibility of a modified version of the Brighton paediatric early warning score (PEWS) in our department.

Methods The PEWS consists of respiratory, circulatory and behavioural parameters with 0–3 points assigned for each category. Persisting postoperative vomiting and continuous inhalation medications give 2 extra points each. Hence, a score of 0 to13 can be assigned, score 0 being most favorable.

All acutely referred children in April/May 2011 were scored.

Patients were retrospectively categorized into diagnose groups. We included patients with score 0 (n=89) and those with scores ≥4 (n= 49).

Results The 0 group:

Sixty percent of patients considered to be well enough to be sent home without admittance to the ward had a PEWS of 0. Only 10% of patients that were admitted had a PEWS of 0. Allergic reactions (excl. anaphylaxis), arthritis, vasculitis, abnormal head circumference, psychosomatic disorders, constipation and upper respiratory tract infection typically gave low PEWS.

The ≥ 4 group:

Diagnoses like asthma, bronchiolitis and other lower respiratory tract infections gave almost invariably high PEWS. In addition, cardiological conditions gave PEWS ≥4.

PEWS scoring varied with age as 18/35 (60 %) of 0–2 year olds scored ≥ 4, 11/20 (55 %) at 2 years and only 17/83 (20 %) of patients >3 years scored ≥4.

Conclusions The modified PEWS may be a useful method to detect high-risk patients in our department.

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