National Early Warning Score 2 (NEWS2)
Standardized early warning score to detect clinical deterioration in hospitalized patients and guide escalation of care
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- ICU, Inpatient
Calculate
Answer every item. The result uses the same scoring code Scribeable runs in notes. Nothing you enter leaves this page.
4 to 80 breaths/min.
50 to 100 %.
Hypercapnic respiratory failure with a prescribed SpO2 target of 88-92% (use SpO2 Scale 2)
On supplemental oxygen
30 to 300 mmHg.
20 to 300 beats/min.
Consciousness (ACVPU)
25 to 45 °C.
Enter the values above to see the result.
When it activates
Scribeable activates a calculator from the encounter. The National Early Warning Score 2 (NEWS2) can activate when the transcript or pasted chart context documents any of these:
- Clinical deterioration assessment
- Rapid response team activation criteria
- Acute illness severity monitoring
- Floor patient escalation decision
- Sepsis or deterioration screening
Note-type scope: it activates on notes whose subject resolves to critical care, emergency medicine, hospital medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
7 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Respiratory rate (breaths/min) | vital | /min | NEWS2: ≤8=3, 9–11=1, 12–20=0, 21–24=2, ≥25=3. |
| SpO2 percentage (use Scale 1 for most patients; Scale 2 for confirmed hypercapnic respiratory failure, e.g., COPD) | vital | % | NEWS2 Scale 1: ≤91=3, 92–93=2, 94–95=1, ≥96=0. Scale 2 (COPD) differs. |
| On supplemental oxygen (air = 0, oxygen = 2) | vital | On supplemental oxygen (NEWS2: 2 points). | |
| Systolic blood pressure (mmHg) | vital | mmHg | NEWS2: ≤90=3, 91–100=2, 101–110=1, 111–219=0, ≥220=3. |
| Pulse rate (bpm) | vital | bpm | NEWS2: ≤40=3, 41–50=1, 51–90=0, 91–110=1, 111–130=2, ≥131=3. |
| Level of consciousness: Alert (A=0), new Confusion or responds to Voice/Pain/Unresponsive (C/V/P/U=3) | exam |
| ACVPU: Alert scores 0; any new confusion or lower response scores 3. |
| Temperature (°C) | vital | °C | NEWS2: ≤35.0=3, 35.1–36.0=1, 36.1–38.0=0, 38.1–39.0=1, ≥39.1=2. |
Scoring
Respiration rate: ≤8 (3), 9-11 (1), 12-20 (0), 21-24 (2), ≥25 (3). SpO2 Scale 1: ≤91 (3), 92-93 (2), 94-95 (1), ≥96 (0). SpO2 Scale 2: ≤83 (3), 84-85 (2), 86-87 (1), 88-92 (0), 93-94 on O2 (1), 95-96 on O2 (2), ≥97 on O2 (3). Air/oxygen: Air (0), Oxygen (2). Systolic BP: ≤90 (3), 91-100 (2), 101-110 (1), 111-219 (0), ≥220 (3). Pulse: ≤40 (3), 41-50 (1), 51-90 (0), 91-110 (1), 111-130 (2), ≥131 (3). Consciousness: Alert (0), C/V/P/U (3). Temperature: ≤35.0 (3), 35.1-36.0 (1), 36.1-38.0 (0), 38.1-39.0 (1), ≥39.1 (2). Total range: 0-20.
NEWS2 aggregate from RR Respiratory rate (breaths/min), SpO2 SpO2 percentage (use Scale 1 for most patients; Scale 2 for confirmed hypercapnic respiratory failure, e.g., COPD)%, supp O2 On supplemental oxygen (air = 0, oxygen = 2), SBP Systolic blood pressure (mmHg), pulse Pulse rate (bpm), consciousness Level of consciousness: Alert (A=0), new Confusion or responds to Voice/Pain/Unresponsive (C/V/P/U=3), temp Temperature (°C)°C
Interpretation
Score 0-4: Low risk — routine ward monitoring every 4-6 hours. Score of 3 in any single parameter: Low-medium risk — urgent bedside assessment, increase monitoring to hourly. Aggregate 5-6: Medium risk — urgent response, at least hourly monitoring, consider HDU. Aggregate ≥7: High risk — emergency response, continuous monitoring, consider ICU transfer. NEWS2 SpO2 Scale 2 should be used ONLY for patients with confirmed hypercapnic respiratory failure (typically COPD with target SpO2 88-92%).
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Royal College of Physicians 2017.
- Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHSRCP (NEWS2) 2017 · 2017 · RCP · Consensus · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the National Early Warning Score 2 (NEWS2) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a National Early Warning Score 2 (NEWS2) value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a mandatory rule-out score: a missed result carries acute harm, so the activation filter never approves it on uncertainty.
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