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  National Early Warning Score 2 (NEWS2)

 
Input
 
Respiratory Rate  
Hypercapneic respiratory failure No (Scale 1)

Yes (Scale 2)
On supplemental O2 No

Yes
O2 Saturation  
Systolic Blood Pressure  
Pulse  
Consciousness Alert

CVPU
Temperature  

 
Results
 
 
Respiratory Rate Points  
Oxygen Saturation Points  
Oxygen Use Points  
Systolic BP Points  
Pulse Points  
Consciousness Points  
Temperature Points  

 
National Early Warning 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 PubMed Logo
  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 2713-6 : %      51733-4 : %      59408-5 : %      
SBP 8480-6 : mmHg      
HR 8867-4 : beats/min      
Temp 8310-5 : 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.

 
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All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer.
 
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