pews_score: Pediatric Early Warning Score (PEWS)

In cliot: Clinical Indices and Outcomes Tools

Pediatric Early Warning Score (PEWS)

Description

Calculates the Pediatric Early Warning Score (PEWS) based on the Monaghan (Brighton) methodology. This score is used to identify pediatric patients at risk for clinical deterioration. It evaluates three physiological domains (Behavior, Cardiovascular, Respiratory) and includes adjustments for nebulizer use and persistent vomiting.

Usage

pews_score(behavior_score, cardiovascular_score, respiratory_score,
           nebulizer_use, persistent_vomiting)

Arguments

behavior_score	Numeric (0-3). 0: Playing/Appropriate. 1: Sleeping. 2: Irritable. 3: Lethargic/Confused or reduced response to pain.
cardiovascular_score	Numeric (0-3). 0: Pink or Capillary Refill (CRT) 1-2s. 1: Pale or CRT 3s. 2: Grey or CRT 4s or Tachycardia of 20 bpm above normal. 3: Grey/Mottled or CRT >=5s or Tachycardia of 30 bpm above normal or Bradycardia.
respiratory_score	Numeric (0-3). 0: Within normal parameters, no recession. 1: >10 above normal RR, using accessory muscles, or 30%+ O2 (or >2L/min). 2: >20 above normal RR, recession, or 40%+ O2 (or >4L/min). 3: 5 below normal RR with retractions/grunting, or 50%+ O2 (or >6L/min).
nebulizer_use	Numeric (0 or 1). Use of nebulizer treatment (e.g., every 15 minutes). (1 = Yes, +2 points).
persistent_vomiting	Numeric (0 or 1). Presence of persistent vomiting following surgery. (1 = Yes, +2 points).

Value

A list containing:

PEWS_Score	The calculated total PEWS score.
Risk_Level	Risk stratification (Low, Low-Intermediate, Intermediate, High).
Action_Guidance	Suggested clinical response based on the score.

References

Monaghan A. Detecting and managing deterioration in children. Paediatr Nurs. 2005;17(1):32-35. doi:10.7748/paed2005.02.17.1.32.c964

Examples

# Example 1: Stable Patient
# Behavior 0, CV 0, Resp 0, No neb/vomit
pews_score(0, 0, 0, 0, 0)

# Example 2: High Risk Patient
# Lethargic (3), Grey (2), Retractions (2), On Nebs (1)
# Score = 3 + 2 + 2 + 2 = 9
pews_score(3, 2, 2, 1, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.