1. Nurse or doctor worried about clinical state | 8. Nurse or doctor worried about clinical state | Identical indicators |
2. Airway threat | 1. Airway threat, for example, stridor | Identical indicators |
3. Hypoxaemia:
| 2. Child requiring any amount of oxygen to keep saturations greater than 90% | Indicators different. For the purpose of this study the MAC was positive if SpO2 < 90% in air or any amount of oxygen |
4. Severe respiratory distress, apnoea or cyanosis | 4. Abnormal respiratory observations, that is, recession or accessory muscle used | Indicators different. For the purpose of this study the MAC was positive if there were signs of respiratory distress as per the Advanced Paediatric Life Support guidelines |
5. Tachypnoea | 3. Respiratory rate (outside normal range) | Identical indicators. Different ranges were used in the two systems. Respiratory rate was recorded so MAC was precisely determined |
6. Tachycardia or bradycardia | 5. Bradycardia or tachycardia | Identical indicators. Different ranges were used in the two systems. Heart rate was recorded so MAC was precisely determined |
7. Hypotension | 6. Blood pressure (outside normal range) | Identical indicators. Different ranges were used in the two systems. Systolic blood pressure was recorded so MAC was precisely determined |
8. Acute change in neurological state or convulsion | 7. Level of consciousness (abnormal if only responding to voice or less) | Indicators different. For the purpose of this study the MAC was positive if the conscious level was reduced |
9. Cardiac or respiratory arrest | Not an indicator | Cardiac or respiratory arrest was used as an outcome measure in the original C&VPEWS. The data were therefore available to determine the MAC |