Description

The Dutch Ambulance Pediatric Early Warning Score (DA-PEWS) System is an innovative clinical tool designed to enhance the safety and effectiveness of interhospital ambulance transfers for pediatric patients. This system is specifically tailored for children aged 3 to 18 years, focusing on those who are cardiopulmonary stable and are being transported in medium-complexity ambulances.

Key Features

• Early Detection: DA-PEWS is crafted to recognize early signs of clinical deterioration, enabling ambulance staff to maintain high situational awareness and adhere to established protocols.
• Communication Enhancement: It significantly improves communication both within the ambulance team and between ambulance services and hospitals, ensuring seamless patient handovers.

System Components

• Age-Based Reference Ranges: The system uses age-specific vital sign reference ranges, along with a unique 'worried sign' to assess patient conditions effectively.
• Pocket Cards: Quick-reference pocket cards are provided to staff, aiding in risk stratification and decision-making regarding transport safety and team composition.
• Trend Monitoring: It facilitates monitoring of patient condition trends during transport, guiding decisions on care escalation and consultation with medical managers.

Implementation

The implementation of DA-PEWS includes comprehensive staff training, distribution of pocket cards, an instructional video, and evaluation tools such as questionnaires and interview guides. These components have shown to enhance protocol adherence and standardize communication, despite challenges like limited pediatric transfer frequency and varying background knowledge among staff.

Impact and Feasibility

Studies have demonstrated that DA-PEWS increases uniformity in communication and handovers, making it a valuable asset for ambulance services. The system's educational elements, such as training sessions and pocket cards, serve as key facilitators, making it suitable for broader application across different ambulance services, including both medium- and low-complexity ambulances.

Broader Implementation

For successful broader implementation, similar processes should be followed, though organizational variations may influence outcomes. Overall, the DA-PEWS system stands out as a crucial tool in the management and assessment of pediatric patients during ambulance transport, supporting critical decision-making and enhancing overall healthcare delivery in emergency medical services.