Pediatric Early Warning Score (PEWS)
Why Use
Provides an objective measurement for patients who “look sick.”
When to Use
Pediatric inpatients.
Formula
Pearls / Pitfalls
Originally developed to provide a practical and objective method to identify pediatric inpatients at risk for cardiac arrest. Can be used by staff and providers at all levels to escalate care for sick patients.
Advice
Consider escalation of care in patients with high (≥3) PEWS, including escalating to senior staff, increasing frequency of vital signs measurements and clinical assessments, and/or consultation to an intensive care unit.
More Information
Score interpretation: PEWS ≤2: low risk Reassess as needed PEWS 3-4: intermediate risk Recommended to alert charge nurse and staff MD PEWS ≥5: high risk Recommended to initiate rapid response team Normal parameters as per University of Maryland: Age Awake Heart Rate (bpm) Sleeping Heart Rate (bpm) Respiratory Rate at rest (breaths/min) Systolic Blood Pressure Diastolic Blood Pressure Systolic Hypotension Newborn ≤1 month 100-205 90-160 40-60 67-84 35-53 <60 Infant (1-12 months) 100-180 90-160 30-53 72-104 37-56 <70 Toddler (13 months - 3 years) 98-140 80-120 22-37 86-106 42-63 <70 + (2x Age in years)* Preschool (4-6 years) 80-120 65-100 20-28 89-112 47-72 School Age (7-12 years) 75-118 58-90 18-26 97-120 57-80 Adolescent (13-19 years) 60-100 50-90 12-20 110-131 64-83 <90**