Bedside detection of clinical deterioration. Free to use.
NEWS2 (National Early Warning Score 2) is a validated clinical instrument used to assess bedside detection of clinical deterioration. The instrument contains 7 items.
Source / attribution: Royal College of Physicians, 2017
The instrument's primary construct — bedside detection of clinical deterioration — is operationalized through a fixed set of items, each with a defined response format. This standardisation is what allows NEWS2 scores to be compared meaningfully across clinicians, sites, and studies.
Like all screening or assessment instruments, NEWS2 is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 7 items below to see your NEWS2 score and interpretation.
Each item is scored on a 5-point scale (3–3). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
NEWS2 uses simple summation: each item's selected response is converted to a numeric value, and the values are added to produce a total score. Reverse-scored items are inverted before summation.
Scoring notes: Single score of 3 in any one parameter triggers urgent review. Educational use only.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–4 | Low | Low concern. |
| 5–6 | Medium | Concerning — review within 1 h. |
| 7–20 | High | Critical — emergency response. |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | Respiratory rate (/min) | 9–11 | 1 |
| 2 | SpO2 (%) — scale 1 (no chronic hypercapnia) | 94–95 | 1 |
| 3 | On supplemental oxygen | No | 0 |
| 4 | Systolic BP (mmHg) | 101–110 | 1 |
| 5 | Heart rate (/min) | 41–50 | 1 |
| 6 | Consciousness | Alert | 0 |
| 7 | Temperature (°C) | ≥ 39.1 | 2 |
Add up all the item scores you noted in Step 1.
1 + 1 + 0 + 1 + 1 + 0 + 2 = 6
Find the row in the interpretation table whose range contains your total:
Total = 6 falls between 5 and 6 → Medium
Medium. Urgent review by clinician within 1 h.
A score is one input alongside history and examination. NEWS2 supports clinical judgment — it does not replace it.
If NEWS2 doesn't fit your context, related instruments in critical-care include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| qSOFA | Bedside identification of patients at higher risk of poor outcomes from suspected infection | 3 | — |
| APGAR Score | Rapid assessment of newborn at 1 and 5 min | 5 | — |
| ASA Physical Status | Pre-operative health status | 1 | — |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
| CURB-65 | 30-day mortality in community-acquired pneumonia | 5 | — |
| Glasgow Coma Scale | Level of consciousness after head injury | 3 | — |
| HAS-BLED | 1-year risk of major bleeding on oral anticoagulation | 9 | — |
| HEART Score | 6-week MACE risk in ED patients with chest pain | 5 | — |
NEWS2 (National Early Warning Score 2) is a validated instrument that assesses bedside detection of clinical deterioration. It is designed for clinicians, medical students, evidence-synthesis researchers. The 7 items are summed to produce a total score.
NEWS2 contains 7 items. Item scores are summed to produce the total. Scores run from 0 to 20, grouped into 3 interpretation bands from ‘Low’ up to ‘High’.
On the NEWS2 (total score 0–20), scores of 7–20 fall in the ‘High’ band — interpreted as: Critical — emergency response. The full ladder is: 0–4 — Low: Low concern.; 5–6 — Medium: Concerning — review within 1 h.; 7–20 — High: Critical — emergency response. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–4 fall in the ‘Low’ band: Low concern. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
Yes — NEWS2 is in the public domain and free for clinical, educational, and research use without permission. You can use this calculator and the scale itself freely; if you publish results or reproduce the scale, cite the original source paper.
Royal College of Physicians. NEWS2 Standardising the assessment of acute illness severity in the NHS. London: RCP; 2017. This is the original publication for the NEWS2 — the reference to cite when reporting results.
No. NEWS2 is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of bedside detection of clinical deterioration — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
NEWS2 is supported by the following peer-reviewed sources: