title: The use of a modified pediatric early warning score to assess stability of pediatric patients during transport.
abstract: OBJECTIVE
  Pediatric early warning scores (PEWSs) have been used effectively in limited patient care areas. Children's Transport, at Children's Healthcare of Atlanta, transports approximately 5000 children annually. In an effort to consistently assess patient acuity and the impact of our team's interventions, we instituted a modified "transport PEWS" (TPEWS).
  
  
  METHODS
  The existing PEWS was modified to reflect the transport environment. A retrospective chart review was conducted of 100 consecutive children transported by Children's Transport in March 2009. Transport PEWS given during triage by the dispatch center (TPEWStri), TPEWS calculated at referring facility by the team (TPEWSref), and final TPEWS at the accepting institution (TPEWSacc) were compared.
  
  
  RESULTS
  Eighty-six patients were transported by ground. The median age was 50.4 months. Sixty patients (60%) received some intervention from the transport team. Median TPEWSref was 3 (0-9) upon initial assessment, and TPEWSacc was 2 (0-9) on arrival at the accepting facility (P = 0.0001). Seventy-three percent (73/100) of patients were transported to the emergency room; 15 (15%) of 100 to the general inpatient area, and 12 (12%) of 100 to the intensive care unit. In addition, a triage TPEWS (TPEWStri) was calculated from information given from the referring facility in 59 of the 100 patients. A significant difference in TPEWStri and TPEWSref was noted (P = 0.0001).
  
  
  CONCLUSIONS
  In this cohort of pediatric transport patients, TPEWS appears to be a helpful additional assessment tool. Transport PEWS may function as a tool for assessing severity of illness, hence optimizing transport dispatch and patient disposition.
authors.affiliation: Critical Care Division, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. toni.petrillo@choa.org
authors.forename: Toni
authors.initials: T
authors.lastname: Petrillo-Albarano
authors.forename: Jana
authors.initials: J
authors.lastname: Stockwell
authors.forename: Traci
authors.initials: T
authors.lastname: Leong
authors.forename: Kiran
authors.initials: K
authors.lastname: Hebbar
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005845:Georgia; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010360:Patient Transfer; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014218:Triage