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Pediatric Early Warning System (PEWS)

Pediatric Early Warning System (PEWS)

What is the Pediatric Early Warning System?

PEWS uses 5 vital signs, including temperature and heart rate, to help the health care team quickly see if there have been any changes to your child’s condition and quickly respond as needed. PEWS gives the healthcare team a “snapshot” of how your child is doing.

Checking vital signs is a routine part of any hospital stay. Tracking key information over time helps nurses and doctors monitor how your child is doing while in hospital.

Vital signs tracking systems have been used in hospitals for many years. Children’s Hospitals in Alberta have routinely been using similar early warning systems as part of patient care. PEWS uses 5 vital signs (instead of only 1) to create a total score. This way, small changes can be picked up more easily, and your healthcare team is able to make changes sooner in your child’s care.

What does the PEWS score do?

By itself, the score doesn’t do anything. It’s a part of your child’s overall health assessment. The scoring ranges help show how sick your child might be. The score helps your healthcare team make care decisions and gives them a common tool to talk to each other about changes they see.

The PEWS categories include:

  • stable
  • watcher
  • unstable

Your healthcare team makes decisions about your child’s plan of care using:

  • information from the PEWS score
  • what your healthcare team knows about your child and their specific situation
  • your input – remember you’re an important part of this healthcare team

For example, a change in PEWS score could cause your healthcare team to review medicines your child needs. It may also help them make changes in the care plan or add more support or therapy.

What does it mean if my child has a high score?

It all depends on your child and the situation. There are some areas of the hospital where we would expect people to have a high PEWS score.

For example:

  • If a child just came out of surgery we know that their PEWS score would be high. We expect that it will get better over time.
  • Some children have pre-existing conditions that will give them a higher score to start than others.

In these cases a high PEWS score could be a normal part of their hospital stay. A change from your child’s baseline score is what your healthcare team will watch for. To make sure your child is safe, it may be necessary to check vital signs even while your child is sleeping.

What is done about the PEWS score or your child’s care will be decided by you and your child’s healthcare team. Talk to them if you have any questions about this.

When and where might this score be seen?

The PEWS score can be seen by nurses, doctors, and other healthcare team members when they open your child’s chart on the computer. This information is not shown in a personal health record.

Talk to your healthcare team if you’re interested in seeing your child’s PEWS score. Remember that the PEWS score is a helpful guide for your care team and is only a single part of your child’s entire assessment. How your child looks and feels along with all of the clinical information gives the best picture of how your child is doing.

It’s important that you let your healthcare team know if you’re worried, notice a difference in your child, or have any questions. You can always ask them to review the score with you and what it means in your situation.

Current as of: September 24, 2019

Author: Early Warning Scores Group - Alberta Health Services