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Paediatric Early Warning Scores

Early warning scores are generated by combining the scores from a selection of routine observations of patients e.g pulse, respiratory rate, respiratory distress, conscious level. Different observations are selected for children and adults due to their naturally different physiological responses. If a child's clinical condition is deteriorating the 'score' for the observations will (usually) increase and so a higher or increasing score gives an early indication that intervention may be required. Early intervention can 'fix' problems and can avoid the need to transfer a child to a higher level of care and thus avoid or reduce harm.

Almost every hospital in the UK uses different PEWS charts and calculates PEWS in different ways. There is limited research into the trigger points for scoring and escalation. Even where a system is in place, usage can be variable, scoring unreliable, and escalation unstructured.

The NHS Institute has been leading a collaboration with peadiatric units across England to address some of the design and implementation issues. The resources available on this site are free to use and adapt.

View films and our early PEWS work 

Listen to Lorraine Major speak passionately about why PEWS is important for children and North Hampshire and Basingstoke NHS Hospitals Foundation Trust.

View presentations about PEWS.

View PEWS Charts          

We can provide prototype PEWS charts and examples from other NHS trusts.

View and download PEWS charts

Collaboration, co-production and testing opportunities

 Click here to read about our work with paediatric units across England.

Other paediatric resources

Click here for signposts to more resources