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PAED: Pediatric Anesthesia Emergence Delirium Scale

2004

A five-item observational scale developed for paediatric emergence delirium after anaesthesia. Its setting and time window differ from general paediatric intensive-care delirium assessment.

At a glance

Purpose
Contextual, historical or service record
Population
Paediatric
Setting
Perioperative
Time
<2 min
Items
5
Score or threshold
Total 0–20; thresholds vary between studies. A score of ≥10 is one studied threshold.

Format: Five behaviours are rated from 0 to 4, with the first three items scored in the opposite direction to the last two. The total ranges from 0 to 20. Studies have used different thresholds and comparisons; a high score needs interpretation in the context of pain, arousal and recovery from anaesthesia.

Primary validation papers

5 identified diagnostic-accuracy papers

Other forms of validation are described in the evidence section. What is counted?

Large-scale clinical implementation

Not yet reviewed.

A focused implementation review has not yet been completed for this profile.

Training and instructions

  • PAED form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
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Tool and original sources

A source for the tool or its access information is linked below. Check the version and current terms before use, copying or adaptation.

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Original and selected diagnostic-accuracy papers

  • Original paperSikich N, Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale. Anesthesiology. 2004;100(5):1138-45. doi: 10.1097/00000542-200405000-00015. PMID: 15114210.

    This is the original published source for PAED. It is the main source for the method, its intended use and the evidence available at publication.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyBajwa SA, Costi D, Cyna AM. A comparison of emergence delirium scales following general anesthesia in children. Paediatric anaesthesia. 2010;20(8):704-11. doi: 10.1111/j.1460-9592.2010.03328.x. PMID: 20497353.

    This diagnostic-accuracy study evaluated PAED in post-anaesthesia care unit against independent subjective clinical assessment by an experienced paediatric anaesthetist. It reported sensitivity of 100% and specificity of 95% in 117 consecutive children younger than 18 years recovering from general anaesthesia.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyJanssen NJ, Tan EY, Staal M, Janssen EP, Leroy PL, Lousberg R, et al. On the utility of diagnostic instruments for pediatric delirium in critical illness: an evaluation of the Pediatric Anesthesia Emergence Delirium Scale, the Delirium Rating Scale 88, and the Delirium Rating Scale-Revised R-98. Intensive care medicine. 2011;37(8):1331-7. doi: 10.1007/s00134-011-2244-y. PMID: 21567109.

    This diagnostic-accuracy study evaluated PAED in paediatric ICU at a tertiary university medical centre against multidisciplinary clinical gold-standard delirium diagnosis. It reported sensitivity of 91% and specificity of 98% in 182 non-electively admitted critically ill children aged 1-17 years; PAED was completed in 144.

    Open PubMed ↗
Multiple DTA studies identifiedRelated context
Classification

Classification

Contextual, historical or service recordAssessment of delirium in children

A tool may belong to more than one category. Select a linked category to see other relevant profiles.

Evidence

Diagnostic-accuracy evidenceMultiple DTA studies identified

Reported sensitivity and specificity

Headline metric source

Later validation or evaluation · 2009; pmid:19645978

Denominator
Reported source unit: 316 (analysis unit not fully reconciled)
Reference standard
Separate clinical assessment of agitation consistent with emergence delirium
85%
Sensitivity
95.9%
Specificity

Earliest DTA evaluation identified in the current audit; see the linked source and methodological caveats.

More evidence and citation details
Full name
Pediatric Anesthesia Emergence Delirium Scale
Also known as
PAED
Evidence summary
multi-study
Diagnostic-accuracy evaluations
5
Reference standard
Separate clinical assessment of agitation consistent with emergence delirium
Citation
Sikich N, Lerman J Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale Anesthesiology. 2004;100(5):1138-45. PMID 15114210
Download RIS ↗ Download BibTeX ↗

Primary validation studies

Distinct primary publications from the current diagnostic-accuracy audit. Reviews and repeated evaluations within one paper are not counted again. Overlapping cohorts have not all been reconciled. Read the counting rules and limitations.

Open 5 identified papers
  1. Bong CL, Ng AS (2009). Evaluation of emergence delirium in Asian children using the Pediatric Anesthesia Emergence Delirium Scale. Paediatric anaesthesia.

    Reference category: other comparator or secondary accuracy evidence.

  2. Bajwa SA, Costi D, Cyna AM (2010). A comparison of emergence delirium scales following general anesthesia in children. Paediatric anaesthesia.

    Reference category: other comparator or secondary accuracy evidence.

  3. Janssen NJ, Tan EY, Staal M, Janssen EP, Leroy PL, Lousberg R, van Os J, Schieveld JN (2011). On the utility of diagnostic instruments for pediatric delirium in critical illness: an evaluation of the Pediatric Anesthesia Emergence Delirium Scale, the Delirium Rating Scale 88, and the Delirium Rating Scale-Revised R-98. Intensive care medicine.

    Reference category: independent clinical reference.

  4. Luetz A, Gensel D, Müller J, Weiss B, Martiny V, Heinz A, Wernecke KD, Spies C (2016). Validity of Different Delirium Assessment Tools for Critically Ill Children: Covariates Matter. Critical care medicine.

    Reference category: independent clinical reference.

  5. Simonsen BY, Skovby P, Lisby M (2020). An evaluation of the Danish version of the Pediatric Anesthesia Emergence Delirium scale. Acta anaesthesiologica Scandinavica.

    Reference category: other comparator or secondary accuracy evidence.

Copyright and reuse
Information checked
2026-07-19

Instrument-specific terms apply. See the access and copyright policy or send a correction.

Base clinical review: 2026-07-29. Instrument description source check: 2026-09-05. Scope and limitations.