Conference abstract

Paediatric early warning scoring systems in humanitarian settings: where is the evidence? what are the opportunities?

Pan African Medical Journal - Conference Proceedings. 2018:9(13).12 Dec 2018.
doi: 10.11604/pamj-cp.2018.9.13.740

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Keywords: PEWS, humanitarian medicine, resource-limited settings, NEWS, humanitarian paediatrics
Poster

Paediatric early warning scoring systems in humanitarian settings: where is the evidence? what are the opportunities?

Stephanie Brown1,&, Martinez Garcia Daniel2

1University of Washington, Seattle, Washington, 2Médecins Sans Frontières, Operational Center Geneva, Geneva

&Corresponding author
Stephanie Brown, University of Washington, Seattle, Washington

Abstract

Introduction: paediatric early warning scores (PEWS) are systems which aim to identify children at increased risk of deterioration by assigning a score based on vital signs and clinical status. A variety of systems have been proposed and in each one, a score above a designated threshold prompts evaluation by a physician. The use of PEWS helps clinical staff identify children who are deteriorating, so they can intervene early and prevent further decompensation.

Methods: a review of the current literature on PEWS, including the use of PEWS in resource limited settings and humanitarian settings, was performed using the PubMed, Embase and Cochrane data bases. MSF has been using PEWS, as well as an adapted version of PEWS termed “Système d’Alerte Précoce en Pédiatrie (SAPP)”, in some of its paediatric projects since 2013. We present the current scoring systems in use, neither of which have been validated in this clinical context.

Results: while current evidence suggests that implementation of PEWS is associated with a reduction in morbidity and mortality, there is little existing literature on the use of such systems in resource limited settings. Furthermore, a review of the literature reveals that there is currently no validated system for use in humanitarian settings.

Conclusion: there is urgent need for an early warning system that is easy to use, reproducible and validated for the context in which MSF and other INGOs work. It is imperative that a reliable system is developed to identify critically ill children and those at risk for further deterioration throughout the levels of care provided in humanitarian settings.