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National Early Warning Score 2 (NEWS2).
Clinical decision-support tool for qualified healthcare professionals. Results are not a diagnosis and should not replace professional clinical judgment.
The National Early Warning Score 2 (NEWS2) is a standardized scoring system for detecting and responding to acute clinical deterioration. It aggregates six physiological observations: respiratory rate, oxygen saturation (SpO₂), temperature, systolic blood pressure, pulse rate, and level of consciousness (AVPU). Each parameter is scored 0–3 and the total ranges from 0 to 15. NEWS2 is designed to support clinical escalation decisions, not to make a diagnosis. A score of 0 indicates low clinical risk with routine monitoring. Scores of 1–4 suggest low-to-moderate risk and should prompt review by a registered nurse. A score of 5–6, or any single parameter scoring 3, indicates high risk requiring urgent assessment by a clinician with acute illness competencies. A score of ≥7 indicates very high risk requiring emergency assessment, often including ICU or higher-level care. Scale 2 (SpO₂ target 88–92%) is reserved for patients with confirmed chronic hypercapnic respiratory failure who are clinically designated for that target. Do not apply Scale 2 routinely. Limitations: NEWS2 does not identify the underlying cause of deterioration and does not replace comprehensive clinical assessment. Patients with chronically abnormal baseline values (e.g., chronic respiratory disease, long-term oxygen therapy) require individualized interpretation. A low score does not guarantee clinical stability.
Specialty
Emergency MedicineCategory
EmergencyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-06
Formula
Keywords
Normal Range
0–15
Calculates the National Early Warning Score 2 (NEWS2) to standardize the assessment of acute illness severity and trigger appropriate clinical responses.
NEWS2 assigns 0-3 points to each recorded observation using standardized ranges: respiratory rate, oxygen saturation (SpO2 Scale 1 or Scale 2), temperature, systolic blood pressure, and pulse. The total is the sum of the sub-scores, ranging from 0 to 15, with higher totals indicating greater risk of deterioration.
Selects the oxygen saturation scoring scale: Scale 1 for the standard target of 94-98%, or Scale 2 for patients with chronic hypercapnic respiratory failure targeting 88-92%.
Respiratory rate per minute, scored 0-3 (12-20 scores 0; 8 or fewer scores 3).
Oxygen saturation in percent, scored 0-3 according to the selected scale.
Body temperature in degrees Celsius, scored 0-3 (36.1-38.0 scores 0; 35.0 or lower scores 3).
Systolic blood pressure in mmHg, scored 0-3 (111-219 scores 0; 90 or lower scores 3).
Pulse rate in beats per minute, scored 0-3 (51-90 scores 0; 40 or lower scores 3).
A NEWS2 score of 0 indicates low clinical risk. Scores of 1–4 suggest low-to-moderate risk; evaluate by a competent registered nurse. A score of 5–6 or any single score of 3 in any parameter indicates high risk; urgent assessment by a clinician with critical care competencies. A score of ≥7 indicates very high risk; emergency assessment, likely ICU admission.
NEWS2 provides a standardized, evidence-based approach to detecting clinical deterioration. It has been shown to improve patient outcomes by enabling early intervention before critical deterioration occurs.
A 72-year-old woman on the surgical ward has respiratory rate 24/min, SpO₂ 93% on air, temperature 38.2°C, systolic BP 100 mmHg, and pulse 110 bpm, and is alert.
Inputs:
Expected Result: NEWS2 sub-scores: RR 2, SpO₂ 2, temperature 1, SBP 2, pulse 1 — aggregate 8, indicating very high clinical risk and requiring emergency clinical assessment.
Score 0: low clinical risk. 1-4: low-to-moderate risk, assess by registered nurse. 5-6 or any single parameter of 3: high risk, urgent clinician assessment. 7 or more: very high risk, emergency assessment, likely ICU admission.
Patients on long-term oxygen may have persistently low SpO2. Use the target SpO2 scoring scale (88-92% or 94-98% as clinically appropriate) rather than the standard SpO2 scale.
No. NEWS2 is validated for adult inpatients. Use the Pediatric Early Warning Score (PEWS) for children.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. NEWS2 should be used as part of a comprehensive clinical assessment and does not replace clinical judgment.