What NEWS2 does
Patients who deteriorate in hospital usually show abnormal vital signs hours before a cardiac arrest or ICU admission. The National Early Warning Score 2 (NEWS2), published by the UK Royal College of Physicians in 2017, turns seven routine observations into a single score so that worsening is spotted and acted on consistently.
The scoring chart
| Parameter | 3 | 2 | 1 | 0 | 1 | 2 | 3 |
|---|---|---|---|---|---|---|---|
| Respiratory rate (/min) | ≤8 | 9–11 | 12–20 | 21–24 | ≥25 | ||
| SpO₂ scale 1 (%) | ≤91 | 92–93 | 94–95 | ≥96 | |||
| Supplemental oxygen | Yes | No | |||||
| Systolic BP (mmHg) | ≤90 | 91–100 | 101–110 | 111–219 | ≥220 | ||
| Pulse (/min) | ≤40 | 41–50 | 51–90 | 91–110 | 111–130 | ≥131 | |
| Consciousness | Alert | New confusion, V, P or U | |||||
| Temperature (°C) | ≤35.0 | 35.1–36.0 | 36.1–38.0 | 38.1–39.0 | ≥39.1 |
Temperatures entered in °F are converted to °C. Scale 2 for SpO₂, used in patients with hypercapnic respiratory failure and a target of 88% to 92%, is not included here.
Worked example
A patient breathes 18 times a minute, has SpO₂ 96% on room air, blood pressure 118 systolic, pulse 96, is alert and has a temperature of 100.6 °F (38.1 °C):
- Pulse 91–110 scores 1; temperature 38.1–39.0 scores 1; all others 0.
- NEWS2 = 2: low, monitor at least every 4 to 6 hours.
Clinical response
| NEWS2 | Risk | Response |
|---|---|---|
| 0 | Low | Routine monitoring, at least every 12 hours |
| 1–4 | Low | Nurse assessment, monitoring every 4–6 hours |
| 3 in one parameter | Low-medium | Urgent ward-based review |
| 5–6 | Medium | Urgent review by a clinician, monitoring at least hourly |
| 7 or more | High | Emergency assessment by a critical care team |
qSOFA
The calculator also gives the quick SOFA score from the Sepsis-3 definitions (2016): respiratory rate ≥22, altered mentation and systolic BP ≤100 each add 1 point. A qSOFA of 2 or more in a patient with suspected infection predicts higher mortality. It is a prognostic flag, not a screening test for sepsis; NEWS2 is generally more sensitive.
Limits
NEWS2 is designed for adults outside pregnancy. Children and pregnant patients use dedicated charts (PEWS, MEWS). Clinical concern should always trigger a review, whatever the score.
This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.