New system to detect child illnesses rolling out in English emergency rooms

The pediatric early warning system (Pews) utilizes a scoring method based on vital signs to determine the urgency of a child’s condition. While already in use for hospitalized children, this winter marks the first time it will be applied in emergency rooms.

This widespread adoption in England will establish Pews as the largest standardized scoring system of its kind globally. Medical professionals will use it to measure and assess vital signs including blood pressure, heart rate, breathing, oxygen levels, and alertness.

A higher score alerts medical staff to potential deterioration, but the system is not intended to replace professional judgment or the input of parents, caregivers, or the children themselves. Concerns can still trigger immediate escalation of care, regardless of the Pews score.

“In fast-paced emergency departments, staff need to quickly recognize when a child’s condition is worsening,” stated Duncan Burton, chief nursing officer for England. “This standardized approach will help them identify warning signs, communicate concerns, and make timely decisions when every moment matters. It also ensures the voices of children, parents, and carers are heard and can prompt action.”

The Pews incorporates age-appropriate charts to account for variations in normal vital signs for infants, children, and adolescents. The system is specifically designed for the demanding environment of A&E departments to facilitate rapid decision-making.

Approximately 6 million children visit A&E in England annually. A similar system for adults is already in use within NHS hospitals.

NHS England is also developing new standards for child care in A&E, with eliminating children’s care in corridors as a top priority.

Dr. Mike McKean, vice-president for policy at the Royal College of Paediatrics and Child Health (RCPCH), expressed his support, stating, “I am delighted to see this initiative being rolled out ahead of the winter period…it will help teams across England improve equity, patient safety and quality of care.”

Prof. Lynn Woolsey, of the Royal College of Nursing, emphasized the importance of early escalation for patient safety, noting that the system “is a vital tool for nursing staff to quickly identify when a child patient is deteriorating, and act.” She also stressed the need for adequate staffing, training, and support to ensure the system’s effective use.

Data from over 90 hospitals currently using the national inpatient Pews system indicates consistently lower rates of cardiac arrests among patients, according to NHS England.