Roland et al reported the Paediatric Observation Priority Score (POPS) for evaluating pediatric patients in the Emergency Department. This can help to identify a patient who has a serious illness. The authors are from Leicester University in England.
Patient selection: pediatric patient in the ED, age < 17 years
Parameters:
(1) oxygen saturation in percent
(2) breathing
(3) AVPU
(4) gut feeling
(5) other (oncology patient, congenital heart disease, significant past medical history = syndromic condition, asthma, diabetes, chronic steroid therapy; cardiac problems; premature deliver, etc))
(6) pulse in beats per minute
(7) respiratory rate in breaths per minute
(8) temperature in °C
(9) age in years
|
Parameter |
Finding |
Points |
|
oxygen saturation |
>= 95% |
0 |
|
|
90 to 94% |
1 |
|
|
< 90% |
2 |
|
breathing |
no distress |
0 |
|
|
audible grunt or wheeze; mild or moderate recession |
1 |
|
|
stridor or severe recession |
2 |
|
AVPU |
alert |
0 |
|
|
responds to voice |
1 |
|
|
responds to pain |
2 |
|
gut feeling |
well |
0 |
|
|
low level concern |
1 |
|
|
high level concern |
2 |
|
other finding |
none |
0 |
|
|
significant past medical history |
1 |
|
|
oncology patient or congenital heart disease |
2 |
where:
• Unconsciousness (U) is not listed but presumably would trigger admission.
|
Parameter |
0 to 1 y |
1 to 2 y |
2 to 5 y |
5 to 12 y |
13 to 16 y |
|
pulse 0 pts |
110-160 |
100-150 |
95-140 |
80-120 |
60-100 |
|
pulse 1 pts |
90-109; 161-180 |
90-99; 151-170 |
80-94;141-160 |
70-79; 121-150 |
50-60; 100-110 |
|
pulse 2 pts |
< 90; > 180 |
< 90; > 170 |
< 80; > 160 |
< 70; > 150 |
< 50; > 110 |
|
RR 0 pts |
30-40 |
25-35 |
25-30 |
20-25 |
15-20 |
|
RR 1pts |
25-29; 41-50 |
20-24; 36-50 |
20-24; 31-40 |
15-19; 26-40 |
12-14; 20-25 |
|
RR 2pts |
< 25; > 50 |
< 20; > 50 |
< 20; > 40 |
< 15; > 40 |
< 12; > 25 |
|
Temp 0 pts |
36-37.5 |
36-38.4 |
36-38.4 |
36-38.4 |
36-38.4 |
|
Temp 1 pts |
35-35.9; 37.6-39 |
35-35.9; 38.5-40 |
35-35.9; 38.5-40 |
35-35.9; 38.5-40 |
35-35.9; 38.5-40 |
|
Temp 2 pts |
< 35; > 39 |
< 35; > 40 |
< 35; > 40 |
< 35; > 40 |
< 35; > 40 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score 16
• A patient with a score >= 8 should have an immediate evaluation.
