National Early Warning Score 2 (NEWS2)
NEWS2 is a track-and-trigger system used in the UK to standardise assessment of acute illness severity based on vital signs and level of consciousness. It triggers clinical response thresholds.
Score 0 if 12-20; 1 if 9-11; 2 if 21-24; 3 if ≤8 or ≥25
Scale 2 for most patients; Scale 1 for those with hypercapnic respiratory failure risk
Scale 2: 0 if 96-100; 1 if 94-95; 2 if 92-93; 3 if ≤91. Scale 1: 0 if 88-92; 1 if 93-95; 2 if 96-100; 3 if ≤87
Score 0 if No; 2 if Yes
Score 0 if 36.1-38.0; 1 if 35.1-36.0 or 38.1-39.0; 2 if ≥39.1; 3 if ≤35.0
Score 0 if 111-219; 1 if 101-110; 2 if 91-100; 3 if ≤90 or ≥220
Score 0 if 51-90; 1 if 41-50 or 91-110; 2 if 111-130; 3 if ≤40 or ≥131
Score 0 if Alert; 3 if any CVPU
Note: NEWS2 replaced the original NEWS in 2017. It includes two SpO2 scales to accommodate patients with hypercapnic respiratory failure.
NEWS2 Scoring Chart
| Parameter | 3 | 2 | 1 | 0 | 1 | 2 | 3 |
|---|---|---|---|---|---|---|---|
| Respiration | ≤8 | 9-11 | 12-20 | 21-24 | ≥25 | ||
| SpO2 (Scale 2) | ≤91 | 92-93 | 94-95 | 96-100 | |||
| SpO2 (Scale 1) | ≤87 | 93-95 | 88-92 | 96-100 | |||
| Supplemental O2 | Yes = 2 | No = 0 | |||||
| Temperature (°C) | ≤35.0 | 35.1-36.0 / 38.1-39.0 | 36.1-38.0 | ≥39.1 | |||
| Systolic BP | ≤90 / ≥220 | 91-100 | 101-110 | 111-219 | |||
| Pulse | ≤40 / ≥131 | 111-130 | 41-50 / 91-110 | 51-90 | |||
| Consciousness | CVPU = 3 | Alert = 0 |
Scoring Table
| Parameter | Points |
|---|---|
| Respiration Rate | ≤8: 3 points 9-11: 1 points 12-20: 0 points 21-24: 2 points ≥25: 3 points |
| Spo2 Scale2 | ≤91: 3 points 92-93: 2 points 94-95: 1 points 96-100: 0 points |
| Spo2 Scale1 | ≤87: 3 points 88-92: 0 points 93-95: 1 points 96-100: 2 points |
| Supplemental O2 | No: 0 points Yes: 2 points |
| Temperature | ≤35.0: 3 points 35.1-36.0: 1 points 36.1-38.0: 0 points 38.1-39.0: 1 points ≥39.1: 2 points |
| Systolic Bp | ≤90: 3 points 91-100: 2 points 101-110: 1 points 111-219: 0 points ≥220: 3 points |
| Pulse | ≤40: 3 points 41-50: 1 points 51-90: 0 points 91-110: 1 points 111-130: 2 points ≥131: 3 points |
| Consciousness | Alert: 0 points CVPU: 3 points |
Interpretation
| Category | Score Range | Action |
|---|---|---|
| ● Low Score | 0-4 | Ward-based response; assess by registered nurse, review within 4 hours |
| ● Medium Score | 5-6 | Urgent ward-based response; assess by clinician with core competencies, review within 1 hour |
| ● High Score | 7-20 | Emergency response; assess by team with critical-care competencies, consider ICU referral, review immediately |
References
- NEWS2: National Early Warning Score (Standardising the assessment of acute-illness severity in the NHS). Royal College of Physicians / NHS England (2017). https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
- NEWS2 and COVID-19 (Appendix 2: SpO2 scale). NHS England / Royal College of Physicians (2020). https://www.england.nhs.uk/wp-content/uploads/2020/05/PR20949_NHS_England_NEWS2_COVID_FINAL_pdf.pdf
This calculator is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
- NEWS2 is validated for adults; use NEWS for children and pregnant women with caution.
- SpO2 Scale 1 should only be used in patients with confirmed or suspected hypercapnic respiratory failure (e.g., COPD with raised CO2).
- A single red flag (score 3 in any parameter) requires urgent assessment regardless of total score.
- NEWS2 is a track-and-trigger tool, not a diagnostic instrument.