Paediatric Early Warning Score (PEWS)
Structured observation-based scoring system to identify children at risk of clinical deterioration. Scores behaviour, cardiovascular, and respiratory domains. Triggers escalation based on total score.
Score interpretation
PEWS 0-2. No immediate concern.
→ Routine observations as per ward protocol. Document and continue monitoring.
PEWS 3-4. Clinical concern. Senior review required within 30 minutes.
→ Inform nurse in charge immediately. Call senior doctor (SpR/Registrar). Increase observation frequency. Consider management plan.
PEWS >= 5. High risk of clinical deterioration. Urgent escalation required.
→ Immediate medical review. Activate paediatric emergency response/rapid response team. ABCDE assessment. Prepare for potential PICU transfer.
Interpretation bands for the PEWS. Apply clinical judgement and local guidance.
References
- Monaghan A. Detecting and managing deterioration in children. Paediatr Nurs. 2005;17(1):32-35.
- Tucker KM, et al. Paediatric Early Warning Score: predictive accuracy in clinical practice. J Adv Nurs. 2009;65(8):1601-1611.
Related
Curated clinical cross-links plus same-class fallbacks.
- Melatonin · Melatonin Receptor Agonist
- Phytomenadione (Vitamin K1) · Vitamin K (clotting factor cofactor)
- Phytomenadione (Vitamin K1) · Vitamin K (Coagulation Factor Synthesis)
- Ibuprofen (Orthopaedic Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor
- Vitamin K (Phytomenadione) · Vitamin / Haemostatic
- Chloral Hydrate · Sedative (Procedural)
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.