Objective: To review the available evidence on effectiveness of the pediatric early warning score (PEWS) in predicting clinical deterioration in children in healthcare settings. Materials and methods: The electronic databases like PubMed, Google Scholar, etc., were searched up to December 2018, systemically using keywords including early warning scoring system, rapid response, pediatric, and severity of illness. Studies included should have used PEWS for assessing the severity in children in bedside, emergency, and oncology settings. The outcome had to identify the clinical deterioration in children and shifting to PICU/activation of the rapid response team. Results were normatively synthesized. Results: On total screening of 1,254 papers, 52 papers met the criteria and 10 papers were included to write the review article as it met the inclusion criteria. It revealed that PEWS is used extensively in varied settings. But still PEWS had limited use because of variation of scores according to settings. Positive outcomes were identification of sick children and intervention with multidisciplinary team work and effective communication and confidence in treating children. Conclusion: Despite many studies reporting the usefulness of PEWS, no evidence was available for which PEWS to be used. Further research on PEWS is needed for assessing the impact of PEWS implementation and outcome in resource-limited settings.
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