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Watcha: Watcha emergence delirium scale

1992

A simple post-anaesthetic arousal and agitation rating used in children. It may identify hyperactive emergence behaviour but is not specific for delirium and overlaps with pain, fear and distress.

At a glance

Purpose
Contextual, historical or service record
Population
Paediatric
Setting
Perioperative
Time
variable
Score or threshold
Watcha >2

Format: It is a paediatric instrument for paediatric use in Perioperative. The stated administration time is variable. The published result is recorded using Watcha >2.

Primary validation papers

1 identified diagnostic-accuracy paper

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

Public training resources have not yet been confirmed in this review. Check the linked developer or original source for instructions.

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Tool and original sources

No direct copy is linked here. The original paper and a Google Images search are available below. Image results may be unofficial; check the version and source before use.

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Original and selected diagnostic-accuracy papers

  • Original sourceWatcha MF, Ramirez-Ruiz M, White PF, Jones MB, Lagueruela RG, Terkonda RP. Perioperative effects of oral ketorolac and acetaminophen in children undergoing bilateral myringotomy. Canadian journal of anaesthesia = Journal canadien d'anesthesie. 1992;39(7):649-54. doi: 10.1007/BF03008224. PMID: 1394752.

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

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  • 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 Watcha in post-anaesthesia care unit against independent subjective clinical assessment by an experienced paediatric anaesthetist. It reported sensitivity of 100% and specificity of 79.8% in 117 consecutive children younger than 18 years recovering from general anaesthesia.

    Open PubMed ↗
One DTA study 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 evidenceOne DTA study identified

Reported sensitivity and specificity

Headline metric source

Later validation or evaluation · 2010; pmid:20497353

Denominator
Reported source unit: 117 (analysis unit not fully reconciled)
Reference standard
Experienced paediatric anaesthetist's subjective assessment of emergence delirium
100%
Sensitivity
79.8%
Specificity

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

More evidence and citation details
Full name
Watcha emergence delirium scale
Also known as
Watcha scale
Evidence summary
single-comparative-study
Diagnostic-accuracy evaluations
1
Reference standard
Experienced paediatric anaesthetist's subjective assessment of emergence delirium
Citation
Watcha MF, Ramirez-Ruiz M, White PF, Jones MB, Lagueruela RG, Terkonda RP Perioperative effects of oral ketorolac and acetaminophen in children undergoing bilateral myringotomy Can J Anaesth. 1992;39(7):649-654. PMID 1394752
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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 1 identified paper
  1. 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.

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.