Article Text

Download PDFPDF
Case-controlled study
Early warning tools may assist in the identification of clinical deterioration in the new-born nursery
  1. Christopher Parshuram1,2,
  2. Karen Dryden-Palmer2
  1. 1Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
  2. 2Center for Safety Research, Child Health Evaluative Sciences, The Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
  1. Correspondence to: Dr Christopher Parshuram, Department of Paediatrics, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada; christopher.parshuram{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Commentary on: OpenUrl

Implications for practice and research

  • Prospective identification of new-born infants in maternity wards who are clinically deteriorating may be assisted with the use of early identification tools.

  • Differences in physiological norms between late preterm, early-term and post-term new-born infants may limit the performance ‘one size fits all’ neonatal early warning tools.

  • Additional research about ‘early warning’ tools for new-born infants in maternity wards is needed. Specifically, refinement and re-evaluation of identification criteria are required to optimise detection characteristics as there is limited consensus on ‘critical’ and ‘subcritical’ physiological indicators for new-born populations.

  • Further consideration of how provider expertise is integrated within the tools to support timely identification is also required.


Neonates in maternity nurseries are undergoing complex transitions from the intrauterine environment to …

View Full Text


  • Competing interests CP has shares in a clinical decision support company, and is a named inventor of the Bedside Paediatric Early Warning System—a documentation-based system of care for hospitalised children.

  • Provenance and peer review Commissioned; internally peer reviewed.