National Early Warning Score 2 (NEWS2)
Updated Royal College of Physicians early warning score for detecting clinical deterioration in adults. Adds new SpO2 Scale 2 for hypercapnic respiratory failure. Score triggers escalation thresholds. Endorsed by NHS England.
Score interpretation
NEWS2 0–4 — low risk; routine monitoring appropriate
→ 4–6 hourly observations; nursing assessment; escalate if score increases; any single parameter score of 3 = 'clinical concern' — consider earlier review
NEWS2 5–6 — medium risk OR any single score ≥3
→ Urgent review by ward doctor or nurse practitioner within 1 hour; consider transfer to monitored environment; continuous monitoring; reassess after any intervention; inform senior clinician if concerns persist
NEWS2 ≥7 — high risk; emergency response required
→ Continuous monitoring; immediate assessment by medical team competent in managing critical illness; consider HDU/ICU transfer; involve critical care outreach team (if available); NEWS2 ≥5 in COVID-19 patient → immediate senior review
Interpretation bands for the NEWS2. Apply clinical judgement and local guidance.
References
- Royal College of Physicians. National Early Warning Score (NEWS) 2. 2017. RCP London.
Related
Curated clinical cross-links plus same-class fallbacks.
- Human Chorionic Gonadotrophin (hCG) · Gonadotrophin (Ovulation Trigger)
- Lissamine Green 1% Eye Drops · Vital Dye — Ocular Surface Staining (Dry Eye Diagnosis)
- Ceftriaxone (Paediatric) · Third-Generation Cephalosporin — Meningitis / Sepsis / Community-Acquired Pneumonia
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Piperacillin-Tazobactam (Burns — Sepsis) · Antibiotic — Extended-Spectrum Penicillin + Beta-Lactamase Inhibitor
- Meropenem (Burns — Severe Sepsis/MDR) · Antibiotic — Carbapenem
- Rapid Sequence Induction (RSI) · DAS 2015 / AAGBI
- ICU Sedation and Analgesia · SCCM / NICE CG83
- Vasopressor Escalation in Shock · Surviving Sepsis Campaign 2021
- Tracheostomy Management · NTSP / ICS guidelines
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.