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PEDIATRIC EARLY WARNING SCORE
12+ TH
Tanggal Jam
Frek.observasi
AB
35
RR Hitung 60'
30 25 20
AIRWAY &
15
BREATHING
10
RR SKOR BERAT Resp
Effort
SEDANG RI NGAN NORMAL SKOR ALAT
R A: R o o m Air NC : Nas al C anule F M : F ace M a s k
Terapi O2
>2L ≤2L
T: Tra cheo s t o my C P AP ©/ B iP AP (B )
TEKANAN
L/min
SKOR ≥94% 90-93%
SpO2
88-89% ≤85% SKOR
C
150 140
HR Hi tung
60'
CIRCULATION
130 120 110
Jika skor HR ≥ 1
100
cek TD &CRT
90
sentral kmd
80
lanjut ke
70
protokol sepsis
60 50
HR 2 ≤2 SKOR 160 150 140
TD
130 120 110 100
SISTOLIK
90 80 70
TD (S/D) SKOR
PK:Pink M:Mott led P:Pale C:Cyanosis
WAR NA KULIT
D
Disability
SPONTAN SUARA
AVPU
NYERI RESPON -
E Exposure
SKOR ≥40.0
Tax
38.0
Ji ka s uhu 38.5= s e ps i s
36.0
Jk UO