NEWS2 Score
National Early Warning Score 2 — identifies patients at risk of deterioration
How to use & interpret
NEWS2 (National Early Warning Score 2) is the standard UK track-and-trigger score for detecting and responding to acute clinical deterioration in adults. It aggregates respiratory rate, oxygen saturation (with a separate SpO₂ scale for those at risk of hypercapnic respiratory failure), any supplemental oxygen, temperature, systolic blood pressure, pulse and level of consciousness (ACVPU).
Thresholds drive the response: a low score prompts routine monitoring; a single parameter scoring 3, or an aggregate of 5–6, prompts urgent review; an aggregate of 7 or more triggers an emergency, critical-care-level response. New confusion scores under the consciousness parameter and should prompt sepsis screening.
Score interpretation
NEWS2 0–4: Low clinical risk
→ 4-hourly observations minimum; ward-based monitoring
NEWS2 5–6: Medium clinical risk
→ Urgent review by ward-based doctor; consider HDU. Also triggered by any single parameter score ≥3.
NEWS2 ≥7: High clinical risk
→ Emergency assessment by critical care-competent team; continuous monitoring; consider ICU
Interpretation bands for the NEWS2. Apply clinical judgement and local guidance.
Frequently asked questions
When should I use the SpO₂ Scale 2?
Scale 2 is used only for patients with a known target range of 88–92% (e.g. some COPD) and must be a documented clinical decision; everyone else uses Scale 1.
References
- Royal College of Physicians. National Early Warning Score (NEWS) 2. London: RCP, 2017.
Related
Curated clinical cross-links plus same-class fallbacks.
- Human Chorionic Gonadotrophin (hCG) · Gonadotrophin (Ovulation Trigger)
- 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
Featured in these MRCEM clinical pathways
The NEWS2 is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.