NEWS2 Calculator | National Early Warning Score 2

NEWS2 Calculator

Respiration Rate (breaths/min)

SpO₂ — Scale 1 (standard; no hypercapnic risk)

⚠ For patients with hypercapnic respiratory failure target SpO₂ 88–92%, use Scale 2 scoring below instead.

SpO₂ — Scale 2 (COPD / hypercapnic risk — overrides Scale 1 if applicable)

Supplemental Oxygen

Systolic BP (mmHg)

Pulse Rate (bpm)

Consciousness (AVPU)

Temperature (°C)

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NEWS2 Score

Clinical Response Thresholds

NEWS2	Risk Level	Minimum Clinical Response	Monitoring Frequency
0	Low	Continue routine nursing observations	12-hourly
1–4	Low	Inform bedside nurse; reassess observations	4–6-hourly
3 in any single parameter	Low–medium	Inform bedside nurse; urgent review by clinician	1-hourly
5–6	Medium	Urgent ward review by competent clinician; consider HDU	1-hourly
≥ 7	High	Emergency assessment; consider ICU; inform medical emergency team	Continuous

SpO₂ Scale 2: Use only for patients with an established diagnosis of hypercapnic respiratory failure (COPD, chronic type II respiratory failure). The target SpO₂ in these patients is 88–92% — values within this range score 0 on Scale 2. Patients on supplemental oxygen outside their SpO₂ target score 1–3 pts on Scale 2. Do NOT use Scale 2 routinely as it will create dangerous false reassurance in patients without hypercapnic risk.
New confusion: Any new confusion or delirium scores 3 (AVPU = C/V/P/U). This single flag alone triggers urgent review. Delirium in unwell elderly patients may be the first and only sign of sepsis.
NEWS2 ≥ 5: This is the recommended threshold for suspecting sepsis in NHS protocols. Initiate the sepsis 6 bundle: high-flow oxygen, blood cultures, IV antibiotics, IV fluids, serum lactate, urine output monitoring.
NEWS2 is a trend tool: Serial monitoring is more informative than a single score. A score rising from 2 to 4 in 2 hours is more clinically significant than a static score of 4.
NEWS2 is not validated in pregnancy, children, or patients with spinal cord injuries (who may not mount a tachycardia in autonomic dysreflexia).

Royal College of Physicians. National Early Warning Score (NEWS) 2. Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP, 2017.
Smith GB, et al. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation. 2013;84(4):465–470.
NHS England. Sepsis guidance implementation advice for adults. 2017.