Pediatric Early Warning Score (PEWS)

Estimates risk of clinical deterioration in pediatric patients using vital signs and clinical observations.

Behavior*

Playing / appropriate+0

Sleeping+1

Irritable+2

Lethargic, confused, or responds less to pain+3

Cardiovascular*

Pink or capillary refill 1 to 2 seconds+0

Pale or capillary refill 3 seconds+1

Gray or capillary refill 4 seconds, or tachycardia 20 bpm above normal+2

Gray and mottled, or capillary refill 5 seconds or more, or tachycardia 30 bpm above normal, or bradycardia+3

Respiratory*

Within expected range, no retractions+0

More than 10 above expected range using accessory muscles, or >30% FiO2, or at least 4 L/min+1

More than 20 above expected range with retractions, or >40% FiO2, or at least 6 L/min+2

Five below expected range with retractions and grunting, or 50% FiO2, or at least 8 L/min+3

Nebulizers every 15 minutes*

Persistent vomiting after surgery*