Arch Dis Child Educ Pract Ed 97:208-215 doi:10.1136/archdischild-2011-300976
  • Reviews

Paediatric early warning scores: Holy Grail and Achilles' heel

  1. Damian Roland
  1. Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University of Leicester, Leicester, UK
  1. Correspondence to Damian Roland, University of Leicester, Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester, UK; dr98{at}
  1. Contributors Dr. Damian Roland is sole author of this article.

  • Received 12 September 2011
  • Accepted 28 March 2012
  • Published Online First 3 July 2012


Early Warning Scores (EWS) have become increasingly used by hospitals throughout the world to prevent unexpected admission to intensive care or even death in their inpatient population. It is well known that signs of deterioration are present well before collapse and by a combination of systems, EWS enable healthcare professionals to intervene at an appropriate time. A number of national bodies and regulators in the UK have required the use of Early Warning Scores in locations where children are inpatients. This article attempts to describe the background to their development, identify common problems and provide information for units interested in introducing an EWS into their department.


  • Funding This report is independent research arising from a Doctoral Research Fellowship supported by the National Institute for Health Research. The views expressed in this publication are those of the author and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

  • Competing interests Dr Roland is in receipt of an East Midlands HIEC grant to develop POPS (Paediatric Observation Priority Score) for three children's emergency departments.

  • Provenance and peer review Commissioned; externally peer reviewed.