Paediatric Early Warning Score (PEWS)
Identifies deteriorating children in hospital using age-appropriate vital sign thresholds.
Score interpretation
PEWS 0–2: Low risk. Standard monitoring.
→ Continue routine observations per ward protocol.
PEWS 3–4: Increased risk. Increased monitoring.
→ Alert nurse in charge. Increase obs frequency (min hourly). Consider medical review within 30 min.
PEWS ≥5: High risk. Urgent medical review required.
→ IMMEDIATE paediatric medical review. Inform registrar/consultant. Consider PICU referral if no improvement. Prepare for emergency escalation.
Interpretation bands for the PEWS. Apply clinical judgement and local guidance.
References
- Monaghan A. Detecting and managing deterioration in children. Paediatr Nurs. 2005.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Vancomycin (Paediatric) · Glycopeptide Antibiotic — MRSA / Severe Gram-Positive Infections in Children
- Iron Supplementation (Paediatric) · Iron Supplement — Iron Deficiency Anaemia in Children
Featured in these MRCEM clinical pathways
The PEWS is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
