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Calculator: National Early Warning Score (NEWS2) for acute illness in adults


Calculator: National Early Warning Score (NEWS2) for acute illness in adults

 
Input
 
Respiratory rate  
Hypercapneic respiratory failure No (Scale 1)

Yes (Scale 2)
On supplemental O2 No

Yes
O2 saturation  
Systolic BP  
Pulse  
Consciousness Alert

CVPU
Temperature  

 
Results
 
Important: Inputs must be complete to perform calculation.

 
 
Respiratory rate points  
Oxygen saturation points  
Oxygen use points  
Systolic BP points  
Pulse points  
Consciousness points  
Temperature points  

 
NEWS2  
 

 

 

NEWS2 interpretation

 
0 to 4 points: 0 to 4 points (but no 3-point risk item): Low clinical risk: Ward-based response
  3 or 4 points (including one 3-point risk item): Low-medium clinical risk: 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 the hospital.
  • For patients with hypercapnic respiratory failure (commonly due to chronic obstructive pulmonary disease), the point scoring reflects a target range of 88 to 92% oxygen saturation for patients receiving supplemental oxygen. Points assigned for all the clinical parameters are derived from the NEWS Chart 1: The NEWS scoring system, 2017.[2]
  • BP: blood pressure; 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
 
National Early Warning Score2 = Respiratory_rate_points + Oxygen_saturation_points + Oxygen_use_points + Systolic_BP_points + Pulse_points + Consciousness_points + Temperature_points

 

 
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; 71(3-4).
  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 Available at: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2 (Accessed on February 21, 2020).
Only digits 0 to 9 and a single decimal point (".") are acceptable as numeric inputs. Attempted input of other characters into a numeric field may lead to an incorrect result.

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