Pediatric Nursing & Healthcare

Biography

Biography: Silvana Daniela Espinoza Manjarrez

Abstract

Introduction: Early warning scores use clinical parameters to generate scores that allows identifying patients at risk for clinical deterioration.

Objective: Evaluate the use of the PEWS (pediatric early warning score) score as a marker of early clinical deterioration in pediatric oncology patients that require evaluation by the intensive care team.

Methods: 128 events were reviewed, corresponding to 71 patients with a diagnosis of cancer that required evaluation by the pediatric intensive care unit (PICU) team between December 2013 and October 2015. A PEWS score was assigned in a retrospective manner to each one of the events up to 10 hours before the evaluation by the PICU team. A score of greater than 4 was classified as critical based on vital signs. The events were classified based on the intervention as: PICU consult, medical response team activation and code team activation.

Results: Before evaluation by the PICU team, 78% of the patients had critical PEWS. PICU evaluation ranged from 10 hours before the event to the moment of the event. Of the 182 events, 79 patients (85.9%) that were transferred to the PICU had critical PEWS before the event. Of the remaining 90 events that did not require transfer to the PICU, 65 patients (72.2%) require an intervention to improve their critical condition.

Conclusions: The use of an early warning score is useful to identify clinical deterioration early. The results suggest that the US early warning score would allow for the objective identification of patients at risk for deterioration.