CICER is currently supporting the development of a National Clinical Guideline on a Children's Emergency Medicine Early Warning System, by conducting evidence reviews for the guideline development group. CICER undertook a systematic review to identify and appraise current clinical guidelines on children's emergency medicine early warning systems internationally. The protocol and report of this review can be found below. Following on from that review, CICER is now undertaking a scoping review of paediatric early warning systems (PEWS) more broadly, to identify and describe PEWS that have been validated internationally. The protocol for that review can be found below. 

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 a 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 protocols below set out the steps undertaken for the two CICER reviews, including search strategies, screening, data extraction, quality appraisal, and synthesis.