NEWS2 Score Calculator – National Early Warning Score 2
Clinical observations
Enter the patient's current physiological observations to calculate the aggregate NEWS2.
NEWS2 is calculated from six physiological parameters and the supplemental oxygen adjustment. Results will appear when all required observations are entered.
A score of 3 in any single parameter is a red-score trigger and warrants urgent clinical review, even when the aggregate score is below 5. Follow local escalation protocols and clinical judgement.
About NEWS2
The National Early Warning Score 2 (NEWS2), published by the Royal College of Physicians (RCP), is an aggregate track-and-trigger system for recognising and responding to acute clinical deterioration. It is based on six physiological parameters: respiratory rate, oxygen saturation, systolic blood pressure, pulse rate, level of consciousness/new confusion, and temperature. Supplemental oxygen adds 2 points.
Scoring criteria
| Parameter | Score 3 | Score 2 | Score 1 | Score 0 |
|---|---|---|---|---|
| Respiratory rate (/min) | ≤8 or ≥25 | 21–24 | 9–11 | 12–20 |
| SpO₂ Scale 1 (%) | ≤91 | 92–93 | 94–95 | ≥96 |
| SpO₂ Scale 2 (%) | ≤83; ≥97 on O₂ | 84–85; 95–96 on O₂ | 86–87; 93–94 on O₂ | 88–92; ≥93 on air |
| SBP (mmHg) | ≤90 or ≥220 | 91–100 | 101–110 | 111–219 |
| Pulse (/min) | ≤40 or ≥131 | 111–130 | 41–50 or 91–110 | 51–90 |
| Consciousness | New confusion, V, P or U | — | — | Alert |
| Temperature (°C) | ≤35.0 | ≥39.1 | 35.1–36.0 or 38.1–39.0 | 36.1–38.0 |
| Supplemental oxygen | — | +2 points | — | Room air |
Aggregate score and escalation thresholds
| NEWS2 total | Risk | RCP response threshold |
|---|---|---|
| 0 | Low | Routine ward-based care; minimum 12-hourly observations |
| 1–4 | Low | Ward-based response; generally 4–6-hourly observations |
| Any single parameter = 3 | Low–medium trigger | Urgent ward-based clinical review; at least hourly monitoring until reviewed |
| 5–6 | Medium | Urgent clinical response; at least hourly monitoring |
| ≥7 | High | Emergency clinical response; continuous monitoring |
Clinical notes
Choosing the SpO₂ scale
- Scale 1 is the standard scale for most patients.
- Scale 2 is reserved for patients with confirmed hypercapnic respiratory failure and a prescribed target saturation of 88–92%; its use must be authorised by a competent clinician and documented.
- The supplemental oxygen adjustment (+2) is applied in addition to the selected SpO₂ score.
Important limitations
- NEWS2 is designed for acute illness assessment and monitoring, principally in adults; it is not a diagnostic test and does not replace clinical assessment.
- Do not use NEWS2 as a stand-alone sepsis diagnostic tool or as the sole determinant of treatment, admission, discharge or escalation.
- RCP highlights potential limitations in patients with spinal cord injury, particularly high-level injury, where autonomic dysfunction may affect physiological parameters.
- Use local observation, escalation and oxygen-prescribing protocols. Clinical concern can justify escalation regardless of score.
References
Clinical notes
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