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NEWS2 (National Early Warning Score 2)

Early warning score for acute illness severity from six physiological parameters.

For healthcare professionalsEmergency & acute carev1.0.1

For healthcare professionals / clinical use. Not a self-diagnosis tool.

Your measurements

breaths/min
SpO₂ scale
%
On supplemental oxygen
mmHg
beats/min
Consciousness (ACVPU)

Calculated on your device. Nothing is sent to a server.

Your result will appear here

Enter your measurements, then press Calculate.

Methodology

NEWS2 (Royal College of Physicians, 2017)

Sum of RR, SpO₂ (scale 1 or 2), oxygen, SBP, pulse, consciousness and temperature points (0–20)

The clinical response (frequency of monitoring and escalation) is set by local policy based on these thresholds.

Who it is for
Adults aged 16 and over; not validated in pregnancy or children.
Version
1.0.1

How this calculator works

Where the formula comes from

  • The Royal College of Physicians introduced NEWS in 2012 and updated it as NEWS2 in 2017, adding a second oxygen-saturation scale for patients with hypercapnic respiratory failure and adding new confusion to the consciousness item (ACVPU).[1]
  • A 2013 study showed that the original NEWS discriminated patients at risk of cardiac arrest, unanticipated ICU admission or death within 24 hours.[2]

The inputs

  • NEWS2 scores respiratory rate, oxygen saturation, supplemental oxygen, systolic blood pressure, pulse, consciousness and temperature; each parameter scores 0–3, and supplemental oxygen adds 2.[1]
  • Scale 2 for oxygen saturation is for patients with confirmed hypercapnic respiratory failure and a prescribed target of 88–92%, as decided and documented by a competent clinical decision-maker.[1]

Versions and alternatives

  • A 2019 multi-centre database study compared NEWS and NEWS2 for identifying patients at risk of in-hospital mortality.[3]

Where accuracy falls (published evidence)

  • A 2018 analysis of COPD admissions raised concerns that the Scale 2 changes would lower the scores of some patients who later died, and argued that evidence for Scale 2 was limited.[4]

What guidelines say

  • The RCP response thresholds are: 0–4 low, a score of 3 in any single parameter low–medium, 5–6 medium (urgent response) and 7 or more high (emergency response).[1]
  • The RCP states that NEWS2 supports, but does not replace, clinical judgement.[1]

Sources

  1. 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. https://www.rcp.ac.uk/improving-care/resources/national-early-warning-score-news-2/
  2. Smith GB, Prytherch DR, Meredith P, Schmidt PE, Featherstone PI. 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. doi:10.1016/j.resuscitation.2012.12.016
  3. Pimentel MAF, Redfern OC, Gerry S, et al. A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: a multi-centre database study. Resuscitation. 2019;134:147–156. doi:10.1016/j.resuscitation.2018.09.026
  4. Pimentel MAF, Redfern OC, Gerry S, et al. NEWS 2 – too little evidence to implement? Clin Med (Lond). 2018;18(5):371–373. doi:10.7861/clinmedicine.18-5-371

Compiled from the published sources above. Every statement was agreed independently by three AI research tools (Claude, ChatGPT, DeepSeek) and its source verified in PubMed or Crossref by the Hakeemly editorial team. Not reviewed by a doctor unless stated. Agreed on

Worked example: how to calculate NEWS2

Inputs

Respiratory rate
16 breaths/min
SpO₂ scale
Scale 1 (standard)
SpO₂
97 %
On supplemental oxygen
No
Systolic blood pressure (top number)
120 mmHg
Heart rate
75 beats/min
Consciousness (ACVPU)
Alert
Temperature
37 °C

Result

NEWS2
0

0–4: low clinical risk

An illustration with sample values, worked out with the same method the tool above uses.

Limitations

  • Use SpO₂ scale 2 only for patients with confirmed hypercapnic respiratory failure and a prescribed target of 88–92%, as decided by a competent clinician (RCP 2017).

References

  1. 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. https://www.rcp.ac.uk/improving-care/resources/national-early-warning-score-news-2/

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