by Rachel Mackenzie, SSN, Practice Nurse Developer
“NEWS2 is the latest version of the National Early Warning Score (NEWS), first produced in 2012 and updated in December 2017, which advocates a system to standardise the assessment and response to acute illness.
NEWS2 has received formal endorsement from NHS England and NHS Improvement to become the early warning system for identifying acutely ill patients – including those with sepsis – in hospitals in England.“
NEWS 2 – Scale 1 or 2?
NEWS 2 has been introduced to avoid the overuse of oxygen in patients at risk of hypercapnic respiratory failure and improve monitoring of oxygen delivery.
A decision to put the patient on Scale 2 can be made ONLY BY DOCTORS, CSM’S & RESPIRATORY SPECIALIST NURSES.
Scale 1 is used for patients NOT at risk of Hypercapnic (Type 2 ) Respiratory Failure (Aiming > 94%)
Scale 2 is used for patients WITH or AT HIGH RISK of Hypercapnic (Type 2) Respiratory Failure. These are patients with COPD, Lung diseases, Neuromuscular disease, chest wall deformity, morbid obesity or patients with a previous arterial blood gas showing risk of hypercapnia.
NEW 2 also includes ‘new confusion’ hence the term ACVPU rather that AVPU, to reflect this change.
New onset confusion, disorientation or delirium is a sign of potentially serious clinical deterioration in patients, especially those with confirmed or suspected sepsis. These patients require urgent assessment.
This also includes intoxicated head injuries.
If it unclear whether the confusion is new or usual mental state – it should be assumed to be new until confirmed otherwise.
If you have any queries about the new NEWS 2 scoring or need one of the NEWS 2 reference cards please speak to Rachel Mackenzie and she will more than happy to go through any of the elements with you.