For healthcare professionals
NEWS2 score calculator
The National Early Warning Score 2 (NEWS2) adds up points for respiration rate, oxygen saturation, oxygen use, systolic blood pressure, pulse, consciousness and temperature in adults. The Royal College of Physicians published it in 2017. Higher scores flag acute illness that needs a faster clinical response. This calculator is written for clinicians and is not a diagnosis.
Observations
Enter one set of vital signs. Nothing you enter leaves this page.
What you will see
The NEWS2 total, the points for each parameter, and the clinical risk band.
Educational only, not medical advice. Not a diagnosis. Escalation follows local policy and clinical judgement.
Source
Royal College of Physicians, 2017. The points for each parameter are taken from the open-access (CC BY 4.0) table by Martín-Rodríguez and colleagues, Journal of Personalized Medicine 2021, with new confusion scored as in Algarni and colleagues, PLoS One 2024. The risk bands are from Zhang and colleagues, Frontiers in Medicine 2021 (CC BY). The tests check every band edge, the oxygen rule for scale 2 and the 20-point maximum.
Validated in
Adults. NEWS2 was compared with the original NEWS in 251,266 adult admissions (aged 16 or over) at five UK hospitals (Pimentel 2019). It was studied in 663 adults (over 18) with suspected COVID-19 taken to emergency departments (Martín-Rodríguez 2021), and in a meta-analysis of 18 COVID-19 studies with 6,922 participants (Zhang 2021).
Limits
In patients with documented type II respiratory failure, the NEWS2 changes did not improve discrimination over NEWS, and in patients at risk of it by diagnostic coding they lowered it (Pimentel 2019). At 5 or more, specificity for clinical deterioration in COVID-19 was 0.67 (Zhang 2021). Not for children or for use in place of clinical review.
Points
| Parameter | 3 | 2 | 1 | 0 | 1 | 2 | 3 |
|---|---|---|---|---|---|---|---|
| Respiration rate (per minute) | 8 or less | 9 to 11 | 12 to 20 | 21 to 24 | 25 or more | ||
| SpO2 scale 1 (%) | 91 or less | 92 to 93 | 94 to 95 | 96 or more | |||
| SpO2 scale 2 (%) | 83 or less | 84 to 85 | 86 to 87 | 88 to 92, or 93 or more on air | 93 to 94 on oxygen | 95 to 96 on oxygen | 97 or more on oxygen |
| Air or oxygen | Oxygen | Air | |||||
| Systolic blood pressure (mmHg) | 90 or less | 91 to 100 | 101 to 110 | 111 to 219 | 220 or more | ||
| Pulse (per minute) | 40 or less | 41 to 50 | 51 to 90 | 91 to 110 | 111 to 130 | 131 or more | |
| Consciousness | Alert | New confusion, voice, pain or unresponsive | |||||
| Temperature (°C) | 35.0 or less | 35.1 to 36.0 | 36.1 to 38.0 | 38.1 to 39.0 | 39.1 or more |
Source: Royal College of Physicians 2017 (RCP 2017), as printed by Martín-Rodríguez and colleagues (Martín-Rodríguez 2021). In NEWS2, new confusion is added to the AVPU scale (CVPU) and scores 3, and the maximum score is 20 (Algarni 2024). Scale 2 is for patients with hypercapnic respiratory failure (Martín-Rodríguez 2021).
Worked example: respiration rate 22 (2), SpO2 97% on scale 1 (0), on oxygen (2), systolic blood pressure 120 (0), pulse 95 (1), alert (0) and temperature 37.0 °C (0) give a NEWS2 of 5, medium clinical risk.
What the score means
| Score | Clinical risk | Response |
|---|---|---|
| Aggregate 0 to 4 | Low | Ward-based response |
| 3 in any single parameter | Low-medium | Urgent ward-based response |
| Aggregate 5 to 6 | Medium | Key threshold for urgent response |
| Aggregate 7 or more | High | Urgent or emergency response |
Source: Zhang and colleagues 2021 (Zhang 2021). In their meta-analysis of patients with COVID-19, a NEWS2 of 5 or more had a pooled sensitivity of 0.82, a specificity of 0.67 and an area under the curve of 0.82 for clinical deterioration. In adults with suspected COVID-19 taken to emergency departments, NEWS2 had an area under the curve of 0.825 for death within 48 hours (Martín-Rodríguez 2021).
In a UK study of 251,266 adult admissions, NEWS2 did not improve discrimination of adverse outcomes over the original NEWS in patients with documented type II respiratory failure (Pimentel 2019).
Related calculators
For sepsis, see the qSOFA score calculator and the SOFA score calculator, and for the older inflammatory criteria the SIRS criteria calculator. The shock index calculator divides heart rate by systolic blood pressure. Other bedside scores are listed under For healthcare professionals.
Sources
- Martín-Rodríguez F, Martín-Conty JL, Sanz-García A, et al. Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments. J Pers Med. 2021;11(3):170. doi:10.3390/jpm11030170. Open access (CC BY 4.0). Table 1: NEWS2 points for each vital sign, SpO2 scales 1 and 2; NEWS2 area under the curve 0.825 for 48-hour mortality in 663 adults. pmc.ncbi.nlm.nih.gov/articles/PMC8001393/
- Algarni AM, Alfaifi MS, Al Bshabshe AA, et al. Prognostic accuracy of qSOFA score, SIRS criteria, and EWSs for in-hospital mortality among adult patients presenting with suspected infection to the emergency department (PASSEM): multicenter prospective external validation cohort study protocol. PLoS One. 2024;19(1):e0281208. doi:10.1371/journal.pone.0281208. Open access (CC BY 4.0). Table 2: NEWS2 consciousness item CVPU (new confusion added) scores 3; maximum score 20. pmc.ncbi.nlm.nih.gov/articles/PMC10793907/
- Zhang K, Zhang X, Ding W, et al. The Prognostic Accuracy of National Early Warning Score 2 on Predicting Clinical Deterioration for Patients With COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2021;8:699880. doi:10.3389/fmed.2021.699880. PMID 34307426. Open access (CC BY 4.0). Table 1: clinical risk bands and responses; pooled sensitivity 0.82, specificity 0.67 at 5 or more in 18 studies. pmc.ncbi.nlm.nih.gov/articles/PMC8298908/
- Pimentel MAF, Redfern OC, Gerry S, et al. A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: a multi-centre database study. Resuscitation. 2019;134:147-156. doi:10.1016/j.resuscitation.2018.09.026. Open access (CC BY 4.0). 251,266 adult admissions at five UK hospitals; NEWS2 did not improve discrimination in documented type II respiratory failure. pmc.ncbi.nlm.nih.gov/articles/PMC6995996/
- Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP; 2017. Original publication (cited; the points used here are taken from Martín-Rodríguez 2021 and Algarni 2024, CC BY). www.rcp.ac.uk/improving-care/resources/national-early-warning-score-news-2/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-02. Spotted an error? See About.