The Particulars: The Pediatric Early Warning Score (PEWS) creates values ranging from 1 to 13 to determine the severity of illness in children. Values are created based on behavior, cardiovascular and respiratory parameters, nebulizer use, and persistent postsurgical vomit­ing. High scores indicate if a child is critically ill. The PEWS tool could be used to aid in appropriate placement of children to the ward or pediatric ICU.

Data Breakdown: A study using PEWS scores was conducted in nearly 1,000 pediatric patients admitted to the ward or pediatric ICU from the ED. PEWS scores were greater for those admitted to the pediatric ICU than for those admitted to the ward. A PEWS score of 5 or greater had a sensitivity of 42% and a specificity of 92% in predicting pediatric ICU admission.

Take Home Pearl: A PEWS score of 5 or greater in the ED appears to help identify pediatric patients requiring admission to the pediatric ICU as opposed to the ward.