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Pediatrics early warning score

Asya Agulnik, Alejandra Mendez, Lupe Mora, Peter Forbes, Dora Soberanis, Ricardo Mack, Monica Kleinman, Carlos Rodriguez-Galindo
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Gerri Sefton, Steven Lane, Roger Killen, Stuart Black, Max Lyon, Pearl Ampah, Cathryn Sproule, Dominic Loren-Gosling, Caitlin Richards, Jean Spinty, Colette Holloway, Coral Davies, April Wilson, Chung Shen Chean, Bernie Carter, E D Carrol
Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score...
November 9, 2016: Computers, Informatics, Nursing: CIN
Mary C McLellan, Kimberlee Gauvreau, Jean Anne Connor
OBJECTIVE: Early warning scores, such as the Children's Hospital Early Warning Score (CHEWS), are used by hospitals to identify patients at risk for critical deterioration and trigger clinicians to intervene and prevent further deterioration. This study's objectives were to validate the CHEWS and to compare the CHEWS to the previously validated Brighton Pediatric Early Warning Score (PEWS) for early detection of critical deterioration in hospitalized, non-cardiac patients at a pediatric hospital...
November 4, 2016: Journal of Pediatric Nursing
Juliana de Oliveira Freitas Miranda, Climene Laura de Camargo, Carlito Lopes Nascimento, Daniel Sales Portela, Alan Monaghan, Katia Santana Freitas, Renata Fonseca Mendoza
Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil...
September 2016: Revista Brasileira de Enfermagem
Shannon N Acker, Beth Wathen, Genie E Roosevelt, Lauren R S Hill, Anna Schubert, Jenny Reese, Denis D Bensard, Ann M Kulungowski
Introduction The rapid response team (RRT) is a multidisciplinary team who evaluates hospitalized patients for concerns of nonemergent clinical deterioration. RRT evaluations are mandatory for children whose Pediatric Early Warning System (PEWS) score (assessment of child's behavior, cardiovascular and respiratory status) is ≥4. We aimed to determine if there were differences in characteristics of RRT calls between children who were admitted primarily to either medical or surgical services. We hypothesized that RRT activations would be called for less severely ill children with lower PEWS score on surgical services compared with children admitted to a medical service...
February 2017: European Journal of Pediatric Surgery
Philippe Cavailler, Arnaud Tarantola, Yee Sin Leo, Andrew A Lover, Anne Rachline, Moniboth Duch, Rekol Huy, Ai Li Quake, Yuvatha Kdan, Veasna Duong, Jeremy L Brett, Philippe Buchy
BACKGROUND: Dengue is endemic throughout Cambodia, a country faced with significant health and economic challenges. We undertook a clinical study at the National Paediatric Hospital in Phnom Penh to evaluate clinical diagnostic parameters for dengue and predictors of disease outcome. METHODS: Between September 2011 and January 2013, all consecutive inpatients aged between 1 and 15 years and presenting with suspected dengue were enrolled. They were clinically assessed using both the 1997 and 2009 WHO dengue classifications...
2016: BMC Infectious Diseases
Kimberly Douglas, Jerry Christopher Collado, Sheila Keller
Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations...
October 2016: Critical Care Nursing Quarterly
Lydia Aston, Caron Eyre, Michelle McLoughlin, Rachel Shaw
The objective was to identify evidence to support use of specific harms for the development of a children and young people's safety thermometer (CYPST). We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS). Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods)...
2016: Healthcare (Basel, Switzerland)
Srinivasan Suresh
Emerging changes in the United States' healthcare delivery model have led to renewed interest in data-driven methods for managing quality of care. Analytics (Data plus Information) plays a key role in predictive risk assessment, clinical decision support, and various patient throughput measures. This article reviews the application of a pediatric risk score, which is integrated into our hospital's electronic medical record, and provides an early warning sign for clinical deterioration. Dashboards that are a part of disease management systems, are a vital tool in peer benchmarking, and can help in reducing unnecessary variations in care...
April 2016: Pediatric Clinics of North America
N'Diris Barry, Karen M Miller, Gregory Ryshen, Joshua Uffman, Thomas A Taghon, Joseph D Tobias
INTRODUCTION: The goal of this study was to identify the etiology of events and demographics of patients that experience complications requiring activation of the Rapid Response Team (RRT) during the first 24 h following anesthetic care. METHODS: We performed a retrospective review of the Quality Improvement database from the Department of Anesthesiology & Pain Medicine at Nationwide Children's Hospital. The database was searched to identify those patients who had a RRT evaluation activated within 24 h of receiving anesthesia or procedural sedation...
May 2016: Paediatric Anaesthesia
Y K Wong, C T Lui, K K Li, C Y Wong, M M Lee, W L Tong, K L Ong, S Y H Tang
OBJECTIVE: The objective was to determine the accuracy of the outcome predictive scores (Modified Early Warning Score [MEWS]; Hypotension, Low Oxygen Saturation, Low Temperature, Abnormal ECG, Loss of Independence [HOTEL] score; and Simple Clinical Score [SCS]) in predicting en-route complications during interfacility transport (IFT) in emergency department. DESIGN: This was a retrospective cohort study. METHODS: All IFT cases by ambulances with either nurse-led or physician-led escort, occurring between 1 January 2011 and 31 December 2012, were included...
May 2016: American Journal of Emergency Medicine
Asya Agulnik, Peter W Forbes, Nicole Stenquist, Carlos Rodriguez-Galindo, Monica Kleinman
OBJECTIVES: To evaluate the correlation of a Pediatric Early Warning Score with unplanned transfer to the PICU in hospitalized oncology and hematopoietic stem cell transplant patients. DESIGN: We performed a retrospective matched case-control study, comparing the highest documented Pediatric Early Warning Score within 24 hours prior to unplanned PICU transfers in hospitalized pediatric oncology and hematopoietic stem cell transplant patients between September 2011 and December 2013...
April 2016: Pediatric Critical Care Medicine
Vladimiro L Vida, Chiara Tessari, Alessia Cristante, Roberta Nori, Demetrio Pittarello, Carlo Ori, Paola E Cogo, Egle Perissinotto, Giovanni Stellin
BACKGROUND: The purpose of the study was to evaluate the association between regional oxygen saturation (rSO2) desaturation score (calculated by multiplying the rSO2 < 50% by time in seconds the preoperative baseline value) measured with near-infrared spectroscopy and the peak of lactate with postoperative major morbidities in pediatric patients who undergo cardiac surgery. METHODS: We retrospectively analyzed the postoperative course of 152 patients between January 2012 and December 2013, for whom we continuously monitored cerebral rSO2 using near-infrared spectroscopy and serial arterial blood lactate levels for at least 48 hours...
August 2016: Canadian Journal of Cardiology
Xun Niu, Bradley Tilford, Elizabeth Duffy, Hitomi Kobayashi, Kelley Ryan, Mindi Johnson, Bethany Page, Claire Martin, Rhonda Caldwell, Prashant Mahajan
Pediatric early warning scores in an emergency department may be used in routine patient evaluation of illness severity and resource allocation, thereby positively impacting quality and safety in pediatric care. This prospective nursing study assessed the feasibility and reliability of pediatric early warning scores in a busy, inner-city, level 1 trauma center pediatric emergency department. The pediatric early warning scores demonstrated high interrater reliability (degree of agreement among scorers) (intraclass correlation coefficient = 0...
April 2016: Journal of Nursing Care Quality
Alban-Elouen Baruteau, James C Perry, Shubhayan Sanatani, Minoru Horie, Anne M Dubin
UNLABELLED: Heart rate is commonly used in pediatric early warning scores. Age-related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiogram features that differ from adults and vary with age. Bradycardia is defined as a heart rate below the lowest normal value for age. Pediatric bradycardia most commonly manifests as sinus bradycardia, junctional bradycardia, or atrioventricular block. As a result of several different etiologies, it may occur in an entirely structurally normal heart or in association with concomitant congenital heart disease...
February 2016: European Journal of Pediatrics
Orsola Gawronski, Marta L Ciofi Degli Atti, Vincenzo Di Ciommo, Corrado Cecchetti, Alice Bertaina, Emanuela Tiozzo, Massimiliano Raponi
Hospital mortality in children who undergo stem cell transplant (SCT) is high. Early warning scores aim at identifying deteriorating patients and at preventing adverse outcomes. The bedside pediatric early warning system (BedsidePEWS) is a pediatric early warning score based on 7 clinical indicators, ranging from 0 (all indicators within normal ranges for age) to 26. The aim of this case-control study was to assess the performance of BedsidePEWS in identifying clinical deterioration events among children admitted to an SCT unit...
July 2016: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
John S Murray, Lee Ann Williams, Shelly Pignataro, Diana Volpe
Increasingly, early warning system scores are being introduced into pediatric clinical practice to support the early recognition of and intervention for clinical deterioration in hospitalized children at risk. This integrative review explored what is known about early warning system scores with pediatric patients. Twenty-eight publications, including research, clinical practice articles, and conference abstracts, were identified. Five major concepts emerged from analysis of retrieved documents: overview of pediatric early warning system scores, supplementary benefits, facilitators to successful implementation, barriers to successful implementation, and needed research...
July 2015: Pediatric Nursing
J B Fenix, Catherine W Gillespie, Amanda Levin, Nathan Dean
BACKGROUND: This study compares a Pediatric Early Warning Score (PEWS) to physician opinion in identifying patients at risk for deterioration. METHODS: Maximum PEWS recorded during each admission was retrospectively ascertained from electronic medical record data. Physician opinion regarding risk of subsequent deterioration was determined by assignment to an institutional "senior sign-out" (SSO) list that highlights patients whom senior pediatric residents have identified as at risk...
September 2015: Hospital Pediatrics
Zahra H Rahman, Nicole E Leahy, Kelly Sessler, Andrew Greenway, Logan Sorensen, Kara Breznak, Angela Rabbitts, Holly Macklay, Roger W Yurt
The pediatric early warning score (PEWS) tool helps providers to detect subtle clinical deterioration in non-intensive care unit pediatric patients and intervene early to prevent significant adverse outcomes. Although widely used in general pediatrics, limited studies report on its validation; none report on use with burn-injured patients. New York-Presbyterian/Weill Cornell Medical Center modified a general PEWS system to a burn-specific PEWS and integrated its use into standard practice. This study investigated the external validity of the PEWS process in clinical practice...
May 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Iris M Mandell, Francine Bynum, Lori Marshall, Robert Bart, Jeffrey I Gold, Sarah Rubin
BACKGROUND AND OBJECTIVES: Early unplanned Pediatric Intensive Care Unit (PICU) readmission is associated with greater length of stay and mortality. No tools exist to identify children at risk for PICU readmission. The Pediatric Early Warning Score (PEWS) currently identify children at risk for deterioration on the ward. Our primary objective was to evaluate the ability of PEWS to identify children at risk for unplanned PICU readmission. METHODS: A single-center case-control study of 189 children (38 cases and 151 age-matched controls) 18years or younger transferred from the PICU to the pediatric ward from January 1, 2010-March 30, 2013, at an urban tertiary care children's hospital was conducted...
October 2015: Journal of Critical Care
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