A recent study published in The Lancet Child & Adolescent Health suggests that parents or caregivers may have a better intuition than some traditional early warning systems when it comes to identifying children at risk of deterioration. This study found that caregiver concern for the worsening condition of pediatric patients was strongly associated with critical illness, even after taking into account abnormal vital signs such as heart rate or respiratory rate.
In high-income countries, critical illness in children can be challenging for physicians to distinguish from common minor illnesses until late in the disease. Delayed recognition of deterioration is a common contributing factor to preventable deaths in hospitalized children. Parents or caregivers are often in a good position to detect early signs of deterioration, but many healthcare systems do not currently support their involvement in clinical care.
The study, conducted over 26 months in Australia, analyzed over 73,000 emergency department presentations of pediatric patients, with a focus on caregiver concerns for the child’s worsening condition. The researchers found that patients whose caregivers expressed concern were more likely to experience critical illness requiring admission to the ICU or the need for mechanical ventilation compared to those without documented concerns.
The results suggest that parents and caregivers can be a valuable resource in helping clinicians monitor for deterioration in pediatric patients. The study authors recommend that healthcare systems proactively seek out parent or caregiver concerns and prioritize research that incorporates this into hospital systems for detecting deterioration in children.
For more information, the study titled “Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study” can be found in The Lancet Child & Adolescent Health (2025) with DOI: 10.1016/S2352-4642(25)00098-7.
This valuable insight highlights the importance of listening to and involving parents and caregivers in the healthcare decision-making process, especially when it comes to the well-being of children. Their intuition and observations can provide crucial information that may help identify and address potential health crises early on.
