NEWS2 (National Early Warning Score 2)

Cautions

• For adults aged 16 and over. Do not use it in children under 16 or in pregnant women (the appendix FAQ of the report says it can be used up to 20 weeks of pregnancy, and that an obstetric score should be used after 20 weeks).
• Use Scale 2 only when hypercapnic respiratory failure has been confirmed on blood gas analysis, a target SpO2 of 88 to 92% has been prescribed, and a competent clinical decision maker has chosen it and recorded it in the notes. Otherwise use Scale 1. Scoring a patient with COPD who has no history or findings of hypercapnic respiratory failure on Scale 2 does not follow the report.
• New confusion (C) scores 3. If it is unclear whether the confusion is new or the patient's usual state, treat it as new and rate C until this is settled.
• Even when the total is low, ask for an urgent review if you are concerned, whatever the NEWS2. NEWS2 supports clinical judgement and does not replace it.
• In spinal cord injury (especially tetraplegia or high paraplegia) the score can be unreliable because the autonomic nervous system is disrupted. Use it with caution.
• If a parameter cannot be obtained although the equipment is available, the guidance says a response should start immediately. This calculator gives no score until every parameter is entered.
• The response threshold may be adjusted for an individual patient after clinical assessment (additional guidance of March 2020). In community settings (outside hospital), response thresholds have not been determined.