Pediatric Early Warning Score (PEWS)

By Dr. Costa / June 13, 2025

Identifies pediatric patients at risk for clinical deterioration.

Pediatric Early Warning Score (PEWS) Calculator

Pediatric Early Warning Score (PEWS)

1. Respiratory

Normal respiratory rate, no retractions, SaO2 > 95% 0 pts RR +/- 10 from normal, mild retractions, SaO2 90-95% 1 pt RR +/- 20 from normal, moderate retractions, SaO2 < 90% or O2 required 2 pts RR > 30 from normal or < 10 from normal, severe retractions, gasping, central cyanosis 3 pts

2. Cardiovascular

Normal heart rate, capillary refill < 2 sec, normal pulses 0 pts HR +/- 10 from normal, cap refill 2-3 sec, cool periphery 1 pt HR +/- 20 from normal, cap refill > 3 sec, weak/thready pulses, mottled 2 pts HR > 30 from normal or < 10 from normal, no palpable pulses, hypotension 3 pts

3. Neurological

Alert and appropriate for age 0 pts Irritable/Lethargic, responds to verbal stimulation 1 pt Decreased response to pain, somnolent, difficult to rouse 2 pts Unresponsive, comatose, abnormal posturing 3 pts

4. Behavior

Playing, interacting, comfortable 0 pts Irritable, consolable with difficulty, decreased interaction 1 pt Lethargic, not consolable, no interaction 2 pts Unresponsive, floppy, no response to noxious stimuli 3 pts

5. Fluid Balance

Normal urine output, well hydrated, no vomiting/diarrhea 0 pts Mildly decreased urine output, dry mucous membranes, mild vomiting/diarrhea 1 pt Significantly decreased urine output, sunken fontanelle/eyes, moderate vomiting/diarrhea 2 pts Anuric, severely dehydrated, severe vomiting/diarrhea, shock 3 pts

Total PEWS Score: 0

Author

Dr. Costa

Specialty Doctor, NHS, UK

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Pediatric Early Warning Score (PEWS)

1. Respiratory

2. Cardiovascular

3. Neurological

4. Behavior

5. Fluid Balance

Author

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