About

The National Early Warning Score (NEWS2) is a standardized bedside scoring system developed by the Royal College of Physicians to improve the detection of clinical deterioration in adult patients. It provides a common language for acute care teams, ensuring that signs of physiological instability trigger a timely and appropriate response.

This calculator evaluates six physiological parameters: Respiration Rate, Oxygen Saturation, Systolic Blood Pressure, Pulse Rate, Level of Consciousness or new confusion (ACVPU), and Temperature. It integrates the critical component of supplemental oxygen use. The scoring logic follows the precise matrix where extreme values (e.g., Respiratory Rate ≤ 8 or ≥ 25) accrue maximum points (3). The aggregate score dictates the clinical response, ranging from ward-based monitoring to urgent emergency assessment.

Formulas

The total score is the sum of individual physiological parameter scores. Each parameter is weighted from 0 to 3 based on deviation from the norm.

NEWS = Score(Respiration) + Score(SpO2) + Score(Air/Oxygen) + Score(SBP) + Score(Pulse) + Score(Consciousness) + Score(Temp)

A score of 5 or more represents a key clinical threshold for urgent response. A single parameter scoring 3 also triggers a specific alert level (Red score).

Reference Data

Aggregate Score	Clinical Risk	Response Frequency
0 − 4	Low	Min 12-hourly observation
3 (in single param)	Low-Medium	Min 1-hourly observation
5 − 6	Medium	Min 1-hourly. Urgent Ward Review.
7+	High	Continuous monitoring. Emergency Assessment.

Frequently Asked Questions

ACVPU stands for Alert, Confusion (new), Voice, Pain, Unresponsive. In NEWS2, "Confusion" was added to the standard AVPU scale to better identify patients with delirium or acute deterioration, scoring 3 points just like V, P, or U.

Scale 1 is the standard for most patients. Scale 2 is specifically for patients with hypercapnic respiratory failure (e.g., COPD) who have a recommended target saturation of 88-92%. This tool uses Scale 1 standard thresholds.

The requirement for supplemental oxygen to maintain saturations is a critical indicator of respiratory compromise. Even if saturation levels are normal, the dependency on oxygen adds 2 points to the score.