Pediatric early warning signs (PEWS) are clinical manifestations that indicate rapid deterioration in pediatric patients, infancy to adolescence. A PEWS score or PEWS system refers to assessment tools that incorporate the clinical manifestations that have the greatest impact on patient outcome.[1]
Pediatric intensive care is a subspecialty designed for the unique parameters of pediatric patients that need critical care.[2] The first PICU was opened in Europe by Goran Haglund.[3] Over the past few decades, research has proven that adult care and pediatric care vary in parameters, approach, technique, etc.[4] PEWS is used to help determine if a child that is in the Emergency Department should be admitted to the PICU or if a child admitted to the floor should be transferred to the PICU.[5]
It was developed based on the success of MEWS in adult patients to fit the vital parameters and manifestations seen in children.[citation needed] The goal of PEWS is to provide an assessment tool that can be used by multiple specialties and units to objectively determine the overall status of the patient. The purpose of this is to improve communication within teams and across fields, recognition time and patient care, and morbidity and mortality rates.[6] Monaghan created the first PEWS based on MEWS, interviews with pediatric nurses, and observation of pediatric patients.[7]
Currently, multiple PEWS systems are in circulation. They are similar in nature, measuring the same domains, but vary in the parameters used to measure the domains. Therefore, some have been proven more effective than others, however, all of them have been statistically significant in improving patient care times and outcomes.[8]
^Lambert, Veronica; Matthews, Anne; MacDonell, Rachel; Fitzsimons, John (2017). "Paediatric early warning systems for detecting and responding to clinical deterioration in children: a systematic review". BMJ Open. 7 (3): e014497. doi:10.1136/bmjopen-2016-014497. ISSN 2044-6055. PMC 5353324. PMID 28289051.
^Zimmerman, Jerry J.; Anand, Kanwaljeet J. S.; Meert, Kathleen L.; Willson, Douglas F.; Newth, Christopher J. L.; Harrison, Rick; Carcillo, Joseph A.; Berger, John; Jenkins, Tammara L.; Nicholson, Carol; Dean, J. Michael (2016). "Research as a Standard of Care in the PICU*". Pediatric Critical Care Medicine. 17 (1): e13–e21. doi:10.1097/PCC.0000000000000562. ISSN 1529-7535. PMC 5003779. PMID 26513203.
^Epstein, David; Brill, Judith E (2005). "A History of Pediatric Critical Care Medicine". Pediatric Research. 58 (5): 987–996. doi:10.1203/01.PDR.0000182822.16263.3D. ISSN 0031-3998. PMID 16183804 – via Nature.
^Jarvis, Stuart William; Richardson, Gerry; Flemming, Kate; Fraser, Lorna (2021-11-04). "Estimation of age of transition from children's to adult healthcare for young people with long term conditions using linked routinely collected healthcare data". International Journal of Population Data Science. 6 (1): 1685. doi:10.23889/ijpds.v6i1.1685. ISSN 2399-4908. PMC 8576739. PMID 34805553.
^Gold, Delia L.; Mihalov, Leslie K.; Cohen, Daniel M. (2014). Walthall, Jennifer (ed.). "Evaluating the Pediatric Early Warning Score ( PEWS ) System for Admitted Patients in the Pediatric Emergency Department". Academic Emergency Medicine. 21 (11): 1249–1256. doi:10.1111/acem.12514. ISSN 1069-6563. PMC 4300231. PMID 25377402.
^Agulnik, Asya; Ferrara, Gia; Puerto-Torres, Maria; Gillipelli, Srinithya R.; Elish, Paul; Muniz-Talavera, Hilmarie; Gonzalez-Ruiz, Alejandra; Armenta, Miriam; Barra, Camila; Diaz, Rosdali; Hernandez, Cinthia; Juárez Tobias, Susana; de Jesus Loeza, Jose; Mendez, Alejandra; Montalvo, Erika (2022-03-09). "Assessment of Barriers and Enablers to Implementation of a Pediatric Early Warning System in Resource-Limited Settings". JAMA Network Open. 5 (3): e221547. doi:10.1001/jamanetworkopen.2022.1547. ISSN 2574-3805. PMC 8908074. PMID 35262714.
^Johnson, Mary Anbarasi (2023). "Can PHDU Admissions be Reduced or Prevented in Pediatric Set up with PEWS Score Usage? A Case Review" (PDF). Journal of Healthcare and Advanced Nursing. 1 (1): 4. doi:10.59462/JHAN.1.1.102. Archived (PDF) from the original on 2024-04-11. Retrieved 2024-04-11.
^Fuijkschot, Joris; Stevens, Jikke; Teheux, Lara; de Loos, Erica; Rippen, Hester; Meurs, Maaike; de Groot, Janke (2023-08-07). "Development of the national Dutch PEWS: the challenge against heterogeneity and implementation difficulties of PEWS in the Netherlands". BMC Pediatrics. 23 (1): 387. doi:10.1186/s12887-023-04219-3. ISSN 1471-2431. PMC 10405440. PMID 37550704.
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