All acute NHS hospitals and ambulance services are now using the revised National Early Warning Score (NEWS2).1 NEWS2 is used to measure acute deterioration in hospital and increasingly community nurses and medical staff requesting an emergency ambulance or an emergency hospital admission are being asked to provide the NEWS2 score. This article examines the use of NEWS2 and its appropriateness in community settings.
Early warning scores (EWS) are forms of track and trigger scoring systems. These involve checking basic physiological signs at intervals – tracking and responding to abnormal physiological parameters – triggers.2 Concerns regarding the lack of standardisation of EWS across the NHS led to the development of the National Early Warning System (NEWS).3
NEWS uses six physiological measurements: respiratory rate; oxygen saturation; temperature; systolic blood pressure; heart rate and level of consciousness. Each scores 0–3 and individual scores are added together for an overall score. An additional two points are added if the patient is receiving oxygen therapy. The total possible score ranges from 0 to 20. The higher the score the greater the clinical risk. Higher scores indicate the need for escalation, medical review and possible clinical intervention and more intensive monitoring (see table one).