1565 Use of the Modified Brighton Pediatric Early Warning Score (PEWS) in a Norwegian Department for Children and Adolescents

Abstract

Background and Aims Structured observations and examination are crucial. However, paediatric early warning scoring systems is a relatively new concept. We aimed to investigate the feasibility of a modified version of the Brighton paediatric early warning score (PEWS) in our department. Methods The PEWS consists of respiratory, circulatory and behavioural parameters with 0-3 points assigned for each category. Persisting postoperative vomiting and continuous inhalation medications give 2 extra points each. Hence, a score of 0 to13 can be assigned, score 0 being most favorable. All acutely referred children in April/May 2011 were scored. Patients were retrospectively categorized into diagnose groups. We included patients with score 0 (n=89) and those with scores ≥4 (n= 49). Results The 0 group: Sixty percent of patients considered to be well enough to be sent home without admittance to the ward had a PEWS of 0. Only 10% of patients that were admitted had a PEWS of 0. Allergic reactions (excl. anaphylaxis), arthritis, vasculitis, abnormal head circumference, psychosomatic disorders, constipation and upper respiratory tract infection typically gave low PEWS. The ≥ 4 group: Diagnoses like asthma, bronchiolitis and other lower respiratory tract infections gave almost invariably high PEWS. In addition, cardiological conditions gave PEWS ≥4. PEWS scoring varied with age as 18/35 (60 %) of 0-2 year olds scored ≥ 4, 11/20 (55 %) at 2 years and only 17/83 (20 %) of patients >3 years scored ≥4. Conclusions The modified PEWS may be a useful method to detect high-risk patients in our department.