{
  "abstract": "Why did you do this work? Neonatal presentations to the paediatric emergency department continue to increase. 1 Hypothermia is defined by the World Health Organisation as a core temperature <36.5°C and can be environmental or an indicator of serious bacterial infection.2 Our current Paediatric Early Warning Score (PEWS) chart used to triage neonates only highlights hypothermia with a score when temperature is <36°C.Following a serious adverse event in our department of a hypothermic neonate, our aim was to compare the use of the Newborn Early Warning Track and Trigger 2 (NEWTT2) charts with our standard PEWS chart to evaluate its use in recognition of hypothermia.What did you do? We retrospectively collected data on all neonates (infants <28 days) presenting to the Emergency Department, Royal Hospital for Children in Glasgow, between 1st January 2024-28th February 2024. Data was collected from the electronic medical records database, Trakcare, using initial triage observations collected on all presentations to the emergency department. We used RCPCH recognised PEWS and NEWTT2 charts to assign a score to each patient based on their temperature alone.What did you find? A total of 261 neonates presented to the emergency department during the study period. One patient was brought in deceased for pastoral care and was therefore excluded from the study. Patient characteristics are summarised in table 1.Among the presenting neonates, 40 patients (15.3%) had a temperature score of 1 or more on the NEWTT2 scoring chart, whereas only 4 patients (1.5%) scored 1 or more on the PEWS chart. Of the 4 patients who scored 2 on the NEWTT2 chart (with a corresponding PEWS score of 1), 3 were admitted under the medical team for further evaluation and management. Of these, only one received antibiotic treatment for presumed serious bacterial infection; however, all cultures returned negative.In total, 134 neonates (51%) were discharged home following review, and among these, 17 neonates (43.5% of those with a temperature <36.5°C) were discharged with an initial temperature below 36.5°C.What does it mean? The NEWTT2 scoring charts demonstrate the different emphasis on temperature compared with PEWS. Corresponding scores will therefore differ, potentially altering the numbers of babies admitted from the ED. By employing this new scoring system, healthcare providers can effectively prioritise neonates requiring specific interventions, such as thermoregulation and have a lower threshold for considering septic screening, during triage. Before implementing in an emergency care setting, more work needs to be done to look at how this new scoring system will affect admissions to the inpatient setting. The implementation of this change in practice should be approached with caution, accompanied by well-defined guidelines for clinical management.Abstract 8014 Table 1Patient characteristics Characteristics N (%) Total patients- Males- Females 260150 (57.7)110 (42.3) Age (in days)- Mean- Median- Range 14140-28 Outcomes- Discharged- Admitted- Transferred 134 (51.5)123 (47.3)3 (1.2) Temperatures- < 36- 36-36.4- 36.5-37.5- 37.6-37.9- >38 4 (1.5)36 (14)202 (78)11 (4.2)8 (3) References Retrospective observational study of neonatal attendances to a children’s emergency department; Acta Paediatric Vol 110, Issue 11; S.Blakely, M.Lyttle, D.Magnus; Nov 2021WHO Mother-Baby Package; WHO/FHE/MSM/94.11 Rev.1; Geneva; World Health Organisation; 1997",
  "authors": [
    {
      "affiliations": [
        "NHS"
      ],
      "name": "Anna Godman"
    },
    {
      "affiliations": [
        "NHS Greater Glasgow and Clyde"
      ],
      "name": "Stephanie McCallion"
    },
    {
      "affiliations": [
        "NHS Greater Glasgow and Clyde"
      ],
      "name": "David Rodger"
    },
    {
      "affiliations": [
        "NHS Greater Glasgow and Clyde"
      ],
      "name": "Joanne Stirling"
    }
  ],
  "title": "8014 Recognition of hypothermic neonates in the emergency department: comparing NEWTT2 and PEWS scoring charts",
  "uid": "294b5df3-5655-50a4-9cef-71de75ea8d5f"
}