Abstract
Abstract The concept of using early warning systems to detect deterioration in patients in hospitals is well established in healthcare systems. However their implementation has not always been in parallel with the available evidence. The face validity of tools that alert staff to early changes in physiological and observational parameters is a significant driver to their spread. However there are a number of factors which should give healthcare providers pause for thought. This review examines some common questions raised about PEWS (Paediatric Early Warning Systems) and discusses how we might use them to their maximum potential.
Highlights
There are some illnesses, injuries and disease processes that can’t be altered and regardless of the best medical care, the outcome for some children and young people will always be tragic
Scores vs Systems A number of systematic reviews have explored the range of tools developed in hospital deterioration but there is no one tool that appears to deliver the required specificity and sensitivity
Smaller hospitals are rarely able to provide a rapid response teams in addition to the child’s normal medical and nursing care
Summary
There are some illnesses, injuries and disease processes that can’t be altered and regardless of the best medical care, the outcome for some children and young people will always be tragic. Improvement bodies and regulators have raised concerns over preventable mortality in in-patients but while the chain of events needed to respond to the deteriorating child is clear; the best methodologies of doing this have yet to be clearly defined (Figure 1). Scores vs Systems A number of systematic reviews have explored the range of tools developed in hospital deterioration but there is no one tool that appears to deliver the required specificity and sensitivity. This is a complex area of research as definitions are not universal and outcomes extremely variable. Smaller hospitals are rarely able to provide a rapid response teams (a dedicated group of health care professionals who can be called if there are concerns about a child) in addition to the child’s normal medical and nursing care
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