The world’s largest “early warning system” to spot when sick children are dangerously deteriorating is being introduced in A&E departments across England, NHS leaders have said. The national paediatric early warning system (Pews) uses a scoring system for vital signs to assess whether a child needs more urgent attention. It is already used for inpatients, but NHS England has said this winter will be the first time it is used in A&E.
The mass rollout in England will make Pews the largest standardised scoring system in the world. Doctors and nurses can use it to measure, record and assess vital signs, such as blood pressure, heart rate, breathing rates, oxygen levels and consciousness. A high score helps flag to medical staff when a child is deteriorating, though it was not designed to replace professional judgment or the input of parents, carers and children into a child’s condition, NHS England said.
Concerns raised can still trigger an immediate escalation of care, even if a child’s Pews score is low. Duncan Burton, the chief nursing officer for England, said: “In fast-paced emergency departments, staff need to spot quickly when a child’s condition is deteriorating. The scheme has also been designed specifically for A&E to help with rapid decision-making in busy environments.
More than 6 million children attend A&E in England each year. A similar process for adults, the national early warning system, is already used by NHS hospitals. Separately, NHS England is drawing up urgent new standards for how children should be treated in A&E, including eliminating corridor care for youngsters as a priority.
Dr Mike McKean, the vice-president for policy at the Royal College of Paediatrics and Child Health (RCPCH), which worked on the new Pews system, said: “I am delighted to see this initiative being rolled out ahead of the winter period, which is always a busy and challenging time for hospitals and healthcare professionals.
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