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Early warning scores: a health warning
  1. Kirsty Challen1,
  2. Damian Roland2,3
  1. 1Emergency Department, Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, UK
  2. 2Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospitals, Leicester, UK
  3. 3SAPPHIRE Group, Health Sciences, Leicester University, Leicester, UK
  1. Correspondence to Dr Kirsty Challen, Lancashire Teaching Hospitals NHS Trust, Emergency Department, Royal Preston Hospital, Sharoe Green Lane, Preston PR2 9HT, UK; kirstychallen{at}


Early warning scores are frequently used in UK adult emergency departments (EDs) and are gaining traction in paediatric emergency care. Like many innovations with inherent face validity, they have great appeal to clinicians, managers and commissioners. However, it is important to ensure unintended consequences and balancing measures are mitigated. We review the background to their development and introduction in the ED, the evidence for their usefulness, their limitations in our field and areas for further research.

  • risk management
  • clinical
  • emergency care systems, emergency departments
  • emergency department management
  • paediatrics, paediatric emergency medicine

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  • Twitter Follow Kirsty Challen at @kirstychallen and Damian Roland at @damian_roland

  • Contributors Both authors contributed to the literature searching and manuscript drafting.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement Original literature searches available from the authors.