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National Early Warning Score 2 (NEWS2)

 

Input
 

Respiratory Rate		br/min breaths/min
Hypercapneic respiratory failure	No (Scale 1)
	Yes (Scale 2)
On supplemental O2	No
	Yes
O2 Saturation		% fraction percent rate ratio
Systolic Blood Pressure		Pascal cmH2O mmHg torr
Pulse		beats/min bpm
Consciousness	Alert
	CVPU
Temperature		Cel Degrees C Degrees F degC degF

 
Results
 
Important: Inputs must be complete to perform calculation.

 

Respiratory Rate Points		# count index logit none number points score
Oxygen Saturation Points		# count index logit none number points score
Oxygen Use Points		# count index logit none number points score
Systolic BP Points		# count index logit none number points score
Pulse Points		# count index logit none number points score
Consciousness Points		# count index logit none number points score
Temperature Points		# count index logit none number points score
National Early Warning Score		# count index logit none number points score

 

     
 
Include literature references: Yes   No

 

NEWS interpretation

 

0 to 4 points:	Low clinical risk: Ward based response
	Low-medium clinical risk (if includes one 3-point risk item): Urgent ward based response
5 to 6 points:	Medium clinical risk: Key threshold for urgent response
7 to 20 points:	High clinical risk: Urgent or emergency response

 

 

 

 

Notes

• The NEWS2 is based on a simple aggregate scoring system in which a score is allocated to physiological measurements, already recorded in routine practice, when patients present to, or are being monitored in hospital.
• In the NEWS2 score system, O₂ saturation points are dependent on both the patient condition (eg in patients with hypercapnic respiratory failure, commonly from COPD), and the use of supplemental oxygen to maintain O₂ saturation. Based on these factors, the calculator automatically applies the appropriate O₂ saturation scoring scale (1 or 2).
• CVPU: new Confusion, Voice, Pain, Unresponsive.
  • New confusion: A patient may be alert but confused or disorientated. It is not always possible to determine whether the confusion is "new" when a patient presents acutely ill. Such a presentation should always be considered to be "new" until confirmed to be otherwise. New-onset or worsening confusion, delirium or any other altered mentation should always prompt concern about potentially serious underlying causes and warrants urgent clinical evaluation.
  • Voice: The patient makes some kind of response when you talk to them, which could be in any of the three component measures of eyes, voice or motor -- eg patient's eyes open on being asked "Are you okay?". The response could be as little as a grunt, moan, or slight movement of a limb when prompted by voice.
  • Pain: The patient makes a response to a pain stimulus. A patient who is not alert and who has not responded to voice (hence having the test performed on them) is likely to exhibit only withdrawal from pain, or even involuntary flexion or extension of the limbs from the pain stimulus. The person undertaking the assessment should always exercise care and be suitably trained when using a pain stimulus as a method of assessing levels of consciousness.
  • Unresponsive: This is also commonly referred to as "unconscious". This outcome is recorded if the patient does not give any eye, voice or motor response to voice or pain.

 
Equations used
 

RespiratoryRatePoints = rrp

OxygenSaturationPoints = o2p

OxygenUsePoints = On supplemental O2

SystolicBPPoints = sbpp

PulsePoints = hrp

ConsciousnessPoints = Consciousness

TemperatureeraturePoints = tempp

National Early Warning Score = RespiratoryRatePoints + OxygenSaturationPoints + OxygenUsePoints + SystolicBPPoints + PulsePoints + ConsciousnessPoints + TemperatureeraturePoints

 

 

References

1. Spagnolli W, Rigoni M, Torri E, et al. Application of the National Early Warning Score (NEWS) as a stratification tool on admission in an Italian acute medical ward: A perspective study. Int J Clin Pract. 2017 Mar;71(3-4). PubMed ID: 28276182
2. Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP 2017.

 

Associated Logical Observation Identifiers Names and Codes [LOINC]
 

Parameter	LOINC's and Suggested Units
RR	9303-9 : breaths/min      9279-1 : breaths/min      76170-0 : breaths/min      19840-8 : breaths/min
O2Sat	2708-6 : %      2713-6 : %      51733-4 : %      59408-5 : %
SBP	8480-6 : mmHg
HR	8867-4 : beats/min      8893-0 : beats/min      8890-6 : beats/min      8889-8 : beats/min      68999-2 : beats/min      76282-3 : beats/min      69000-8 : beats/min      69001-6 : beats/min
Temp	8329-5 : degC      8310-5 : degC      8331-1 : degC      8332-9 : degC      8333-7 : degC      8328-7 : degC      75539-7 : degC

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.