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PEDS - PEWS & TRAFFIC LIGHT SYSTEM (traffic light system (1) colour of…
PEDS - PEWS & TRAFFIC LIGHT SYSTEM
what is it
the pews is a workstream of the national clinical programme for pediatrics & neonatology
provides a framework for care and empowers clinicians to act on behalf of a child with sings of deterioration or about whom they have clinical concerns
a national clinical guideline on the irish pews was published by the national clinical effectiveness committee and department of health in november 2015 and updated in november 2016
benefits
to the child
increase potential to identify and review trend's in a child's condition
early warning alarm to flag deterioration
may reduce incidence of unplanned admissions to intensive care
prompts closer monitoring and clinical review
to the family
includes family in assessment
increase potential for identification of subtle signs of deterioration
to the nurse
standardises clinical assessments and recording of observations
empowers nurses to voice their concerns about child's condition
to the doctor
prompts timely medical review
empowers to escalate concerns earlier as appropriate
assists in prioritising the management of their patients
why would you use
core parameters/differences to adults
based on EWS/PEWS
children
there are different pews charts depending on the childs age. for the purpose of this question i will develop the pews chart for 1-4yrs
respirations
20-39
effort of respirations
normal (could be mild/moderate/severe)
room air/02
room air
02 sats
over 94
heart rate
between 80-129
capillary refill time
less than 2seconds
blood pressure
systolic between 90-110
skin colour
pink (could be pale, mottled, cyanosed)
AVPU
alert
temp
between 36-37.9
all score 0 on PEWS
adults
02 sats
above 96
respirations
12-20
heart rate
50-90
blood pressure
systolic of above 110
AVPU
Alert
temperature
36-37.9
Room air/o2
Room air
these all score a 0 on the EWS
traffic light system
1)
colour of skin
green - low risk
normal color
amber - intermediate risk
pallor reported by parent/carer
red - high risk
pale/mottled/ashen/blue
2)
activity
green
responds normally to social cues, content/smiles, stays awake/awakens quickly, normal cry/not crying
amber
not responding normally to social cues, not smiling, awakes only with prolonged stimulation, decreased activity
red
no response to social cues, appears ill to a healthcare professional , does not way/if aroused does not stay awake, weak high pitched/continuous cry.
3)
respiratory
amber
nasal flaring, tachypnoea (RR greater than 50 , 6-12months. RR greater than 40 , over 12mths) oxygen sats less than 95, crackles in chest.
red
grunting, tachypnoea greater than60, moderate/severe chest indrawing
4)
circulation and hydration
green
normal skin&eyes, moist mucous membranes.
amber
tachycardia (160beats less than 12mths, more than 150 12-24mths, more than 140 2-5yrs) capillary refill time greater than 3secs, poor feeding, reduced urine output, dry mucous membranes.
red
reduced skin turgor
5)
other
green
none of the amber or red signs or symptoms
amber
3-6mths, temp up to or equal to 39degrees, fever up to 5days, rigors, swelling of limb/joint, non-weight bearing limb/not using an extremity
red
age less than 3mths w/ temp of 38degrees, nonblanching rash, bulging fontanelle, neck stiffness, status epilepticus, focal seizures, focal neurological signs