This is an unprecedented time. It is the dedication of healthcare workers that will lead us through this crisis. Thank you for everything you do.

      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

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    Specialty

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    Chief Complaint

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    Organ System

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    Patent Pending

    National Early Warning Score (NEWS) 2

    Determines the degree of illness of a patient and prompts critical care intervention (recommended by NHS over original NEWS).

    IMPORTANT

    We launched a COVID-19 Resource Center, including a critical review of recommended calcs.

    Tips for COVID-19: Use for Crisis Standards of Care. Used for subgroup analyses (not for Crises Standards of Care) in Cao et al (2020) NEJM’s Lopinavir-Ritonavir study in COVID-19.

    INSTRUCTIONS

    Recommended by the NHS (UK) over the original NEWS

    When to Use
    Pearls/Pitfalls

    • Patients ≥16 years old.

    • Do not use in children <16 years old or pregnant patients.

    • The Royal College of Physicians recommends the NEWS2 in the following settings:

      • Emergency: for initial assessment, serial monitoring, and assessment for triage.

      • Ward: for initial inpatient assessment and serial monitoring.

      • Prehospital: for communication of illness severity to receiving hospitals.

    May not be reliable in patients with spinal cord injury due to functional disturbance of autonomic responses.

    ≤8
    +3
    9-11
    +1
    12-20
    0
    21-24
    +2
    ≥25
    +3
    No
    Yes
    Supplemental O₂
    +2
    Room air
    0
    ≤35.0°C (95°F)
    +3
    35.1-36.0°C (95.1-96.8°F)
    +1
    36.1-38.0°C (96.9-100.4°F)
    0
    38.1-39.0°C (100.5-102.2°F)
    +1
    ≥39.1°C (102.3°F)
    +2
    ≤90
    +3
    91-100
    +2
    101-110
    +1
    111-219
    0
    ≥220
    +3
    ≤40
    +3
    41-50
    +1
    51-90
    0
    91-110
    +1
    111-130
    +2
    ≥131
    +3
    Alert
    0
    New-onset confusion (or disorientation/agitation), responds to voice, responds to pain, or unresponsive
    +3
    Confirmed positive
    Suspected
    Unlikely
    Confirmed negative

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Gary B. Smith

    About the Creator

    Gary B. Smith, Cert Med, FRCA, FRCP, is a visiting professor at the School of Health & Social Care, University of Bournemouth, UK. He is director of the UK Deteriorating Hospital Patient conference and co-director of the International Conferences on Rapid Response Systems. Professor Smith co-developed RSVP (Reason-Story-Vital Signs-Plan), for communicating patient deterioration and the Chain of Prevention, a paradigm for preventing patient deterioration.

    To view Dr. Gary B. Smith's publications, visit PubMed

    Are you Dr. Gary B. Smith? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Gary B. Smith
    Are you Dr. Gary B. Smith?