NEWS2 — National Early Warning Score Chart
Six physiological parameters, one aggregate score, one escalation threshold — catch the deteriorating patient before the crisis, not after
What it is
The NEWS2 (National Early Warning Score, version 2) chart adapted from the Royal College of Physicians UK. Six parameters are scored at each observation: respiratory rate, oxygen saturation, supplemental oxygen, temperature, systolic blood pressure, heart rate, and level of consciousness. Scores are summed to give a NEWS2 aggregate. A score of 5 or above, or 3 in any single parameter, triggers escalation. The chart includes the escalation response matrix so the nurse knows exactly what to do with each score range — not just what to write.
ASF criterion
Evidence for: Hospital Standard 4, criterion 4.25 (Non-Negotiable) — Deteriorating Patients Are Caught Before the Crisis, Not After. The Monitor will check whether a scoring system is in use AND whether a high score triggered a documented response.
The scoring table
| Parameter | Score 3 | Score 2 | Score 1 | Score 0 | Score 1 | Score 2 | Score 3 |
|---|---|---|---|---|---|---|---|
| Respiratory rate (breaths/min) | ≤8 | 9–11 | 12–20 | 21–24 | ≥25 | ||
| SpO2 Scale 1 (no supplemental O2) | ≤91% | 92–93% | 94–95% | ≥96% | |||
| Supplemental oxygen | Yes | No → 0 | |||||
| Temperature (°C) | ≤35.0 | 35.1–36.0 | 36.1–38.0 | 38.1–39.0 | ≥39.1 | ||
| Systolic BP (mmHg) | ≤90 | 91–100 | 101–110 | 111–219 | ≥220 | ||
| Heart rate (beats/min) | ≤40 | 41–50 | 51–90 | 91–110 | 111–130 | ≥131 | |
| Consciousness (ACVPU) | New confusion, voice, pain, or unresponsive = 3 | Alert = 0 | |||||
Escalation response
| Score 0–4 (Low) | Routine monitoring. Reassess at next scheduled observation. Document score. |
| Score 5–6 or any single 3 (Medium) | Urgent review by registered nurse within 30 minutes. Consider medical review. Increase frequency of monitoring. |
| Score ≥7 (High) | Emergency medical review immediately. Call rapid response team or senior doctor. Do NOT wait. Document time of call and response. |
Observation recording chart
| Patient: | ID: | ||||||||
| Parameter | Time 1 | Score | Time 2 | Score | Time 3 | Score | Time 4 | Score | |
|---|---|---|---|---|---|---|---|---|---|
| Resp rate | |||||||||
| SpO2 (%) | |||||||||
| Supp O2 | |||||||||
| Temp (°C) | |||||||||
| Systolic BP | |||||||||
| Heart rate | |||||||||
| Consciousness | |||||||||
| NEWS2 TOTAL | |||||||||
| Action taken | |||||||||
| Nurse signature | |||||||||
The most common mistake
Calculating the score correctly but not acting on it. A NEWS2 score of 6 with “monitored, no action” documented is a failure — the escalation column exists precisely because calculation without response is meaningless. The Monitor checks the action row, not just the score row.
Translate and adapt
English master edition. Adapted from the Royal College of Physicians NEWS2 (2017) under open licence. Any facility may translate, add its logo, and adapt thresholds to national protocols — keeping the ASF reference code and source attribution. SpO2 Scale 2 (for hypercapnic respiratory failure) available on request.
ASF-TOOL-EWD-01 · Toolkit 34 — Early Warning & Deterioration · france-asf.fr/tools · Adapted from Royal College of Physicians NEWS2 (2017), open licence · ASF layout and evidence mapping © Accréditation Sans Frontières, CC BY-NC-SA 4.0 · Keep this line on all adapted versions
