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Research project

Emergency Department - PEWS: a new early warning score for the ED

Status: Ongoing project

The Paediatric Early Warning Score (PEWS) is a simple score, combining several physiological parameters, that can improve the prioritization of children in the emergency department.

What we do

About our project

Background information

Paediatric Early Warning Scores (PEWS) are increasingly being used in hospital wards to identify children at risk of clinical deterioration, but few have been designed for use in emergency care settings. A new PEWS for use in the ED is needed – based on real-world data – that can accurately identify the small group of seriously ill children who require immediate care, but can also rule out serious illness in the large group of non-urgent patients. So far, no PEWS exists that is applicable to the paediatric ED population, based on real-world data, and validated for use in emergency care settings.

Overall aim

The overall aim of the study is to develop and validate a PEWS whose use could improve the prioritization of children attending an emergency department.

Research method

We make use of observational data from the TrIAGE project based on electronic health record data collected between Jan 1, 2012 and Nov 1, 2015 from five diverse emergency departments in four European countries (Netherlands, the UK, Austria, and Portugal).

Our research focus

Desirable outcome

The ultimate goal is to develop and validate a PEWS that can be successfully used in acute care settings to identify patients of high or low urgency.


Collaborations outside of Erasmus MC

  • St Mary’s, London: I. Maconochie.
  • Hospital Fonseca, Amadora: C.F. Alves, P. Freitas.
  • University Hospital, Vienna: S. Greber-Platz.
  • Maasstad Hospital, Rotterdam: F. Smit.


Development and validation of a Paediatric Early Warning Score for use in the emergency department: a multicentre study.
Zachariasse JM, Nieboer D, Maconochie IK, Smit FJ, Alves CF, Greber-Platzer S, et al. Lancet Child Adolesc Health. 2020;4(8):583-591.

Improving triage for children with comorbidity using the ED-PEWS: an observational study.
Zachariasse JM, Espina PR, Borensztajn DM, Nieboer D, Maconochie IK, Steyerberg EW, et al. Arch Dis Child. 2022;107(3):229-233.

Note: The authors and the developers of the tools are in no way liable for outcomes following the use of the tools. Whilst every effort has been taken during the development of these tools for them to be as accurate and reliable as possible it is important that the user understands they are still a prediction and not an absolute. Any decisions taken whist using these tools are the responsibility of the user and no liability whatsoever will be taken by the developers/authors of the tools or the website owner.

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