SCP: Paediatric Early Warning Scores (PEWS) Short description of the SCP and information on implementation


PEWS provide a systematic approach to enable staff to monitor the sick child using appropriate age-related values. The SCP is to be applied by clinical staff in paediatric units in acute hospital settings for all paediatric patients.

Early warning scores are generated by combining the scores from a selection of routine observations of patients e.g. pulse, respiratory rate, respiratory distress, consciousness 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.

Health care organisations (HCOs) which will implement this SCP within Work Package 5 of the PaSQ Project are expected to introduce Paediatric Early Warning Scores charts into routine care which are based on the PEWS charts developed and tested by the NHS Institute for Innovation and Improvement (see the section on specific tools for PEWS).

It is encouraged that health care organisations modify the charts to suit their needs.

The charts of the NHSIII and those of other hospitals that have used the approach of NHSIII to inform their own chart design can be downloaded free to use and adapt. The NHSIII asks that the source is attributed e.g. adapted from an original design by the NHS Institute for Innovation and Improvement, England.