The Confidential Enquiry into Maternal and Child Health report published in 2008 recommended that there should be a standardised monitoring system with embedded early identification systems for children at risk of critical illness or deterioration. Recent studies have demonstrated improvement in patient outcomes following the implementation of paediatric early warning scores and response teams in children's units and hospitals. However, it is not enough to use an early warning score in isolation; it needs to be embedded into a paediatric early warning system, with a rationalised approach to the observation and monitoring of hospitalised children. Lessons can be learnt from the adult experience of implementing early warning systems. A national, multidisciplinary, collaborative approach to the development, implementation and evaluation of paediatric early warning systems is recommended.
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