The purpose of this review is to identify and appraise current international clinical guidelines on paediatric early warning systems in emergency settings. This work is to support the development of a National Clinical Guideline on a Children's Emergency Medicine Early Warning System in Ireland.

Every year, there are approximately 400,000 visits to Irish emergency departments and injury units by children less than 16 years of age. In the emergency department, a patient's condition may unexpectedly worsen after initial triage, leading to a deterioration in their vital signs, mental status, or other indicators of their overall health. 

Early warning systems (EWSs) are one way to help clinicians identify and communicate clinical deterioration. EWSs are a combination of a recognition scoring system with a response pathway featuring clear escalation actions and plans for patient review and intervention. They are used in healthcare settings to identify and track potential deterioration in a patient's condition. 

Ireland already has guidelines in place for the use of EWSs in adult emergency care and in the paediatric inpatient setting, but does not have a guideline on their use in paediatric emergency care.

The CICER Clinical Guideline Support team has been asked to conduct a review to identify and appraise current international clinical guidelines on paediatric early warning systems in emergency settings.

This protocol sets out the steps planned for this review, including search strategies, screening, data extraction, quality appraisal, and synthesis.