NEWS2 - Acute Care

Question 1

What is NEWS2 and why do we use it?

Answer 1

National Early Warning Score

Used as a standardised measure of acute illness severity - useful due to systematic method to measure physiological parameters in patients >16, also allows for continuous monitoring

Question 2

What are the 2 main ways NEWS2 should be used?

Answer 2

Track - provide continuous record of the patient’s physiological status throughout the patient journey

Trigger - provide standardised platform for the initial assessment of acute illness severity

Question 3

When is NEWS2 not used?

Answer 3

Children <16
Pregnant women
Patients with spinal cord injury (functional disturbances to the ANS)

Question 4

What are the 4 steps to acquire a NEWS2?

Answer 4

1. Measure
2. Record
3. Calculate
4. Identify

Question 5

What are the 6 physiological parameters to do with NEWS2?

Answer 5

RR
O2 sats
Systolic BP
Pulse
Level of consciousness
Temperature

Question 6

What are the 5 levels of consciousness?

Answer 6

Awake / Alert
Confused
Responds to verbal stimulation
Responds to pain stimulation
Unresponsive

Question 7

What are the 2 O2 sats scales?

How many points are added to NEWS2 calculations if the patient is on supplementary oxygen?

What is a score of 3 in a single parameter called?

Answer 7

Scale 1 - normal, pulse oximetry reading
Scale 2 - hypercapnic resp failure

2

Red score - must be flagged and not ignored

Question 8

What is the clinical risk for each of these total NEWS2:

0-4
3 in any individual parameter
5-6
7 or more

Answer 8

0-4 = low
3 in any individual parameter = low-medium
5-6 = medium
7 or more = high

Question 9

What are the 4 key clinical responses to NEWS2?

Answer 9

1. Urgency of response
2. Frequency of ongoing monitoring
3. Seniority and clinical competencies of staff to attend to patient
4. Setting in which ongoing clinical care is delivered

Question 10

What is the urgent response threshold for NEWS2?

Answer 10

Total 5 or more:
Monitored minimum every hour
Inform staff to attend patient
Clinical setting (with monitoring facilities)

Question 11

What are the corresponding clinical responses to each of these total NEWS2:

0
1-4
3 in any individual parameter
5-6
7 or more

Answer 11

0 = minimum 12 hourly

1-4 = minimum 4-6 hourly, registered nurse assesses patient and decides next steps

3 in any individual parameter = minimum hourly, registered nurse informs medical team

5-6 = minimum hourly, registered nurse informs medical team and requests urgent assessment by clinician, requires monitoring facilities

7 or more = continuous monitoring of vital signs, registered nurse informs medical team and specialist at registrar level and practitioner with advanced airway management skills, ICU, requires monitoring facilities

Question 12

At which NEWS2 do you think sepsis?

Answer 12

Total NEWS2 of 5 or more

Score of 3 in a single parameter