Critical Illness Risk Assessment Tool National Early Warning Score version 2 NEWS 2 in Adult Patients CA2000 v12

To provide guidance on the recording of physiological observations and the use of a critical illness risk assessment tool. Furthermore this guideline advises on the action to take when a patient is at risk of acute physiological deterioration. 
Updated vertion also incorporates changes related to development of eOBS and Recognise and Respond Team services.
 
The NEWS2 Call-out-cascade has clear objectives:

1. Identifying an appropriate level and frequency of monitoring
2. Prompt nursing assessment and action to implement simple measures to improve patient’s condition or decision to call Recognise and Respond Team RRT  or Doctor.
3. Rapid medical review of deteriorating patients
4. Early escalation to deteriorating patient teams medical team/RRT if the patient is;
   1. has a NEWS2 socre of 7 or more
   2. has an increase in NEWS2 score of 3 or more
   3. has an increasing oxygen requiredment idneitfying deterioraiton
   4. identified early as at high risk for deterioration
   5.  remains unwell or deteriorates despite initial treatment
   6. needing consideration for  referral to other specialist areas
5. Early consideration and identification of Sepsis as the cause for triggering score
6. Identifying urine output and risk of acute kidney injury in the acutely unwell/deteriorating patient.
7. Identification of ceiling of treatment clarification of resuscitation status for deteriorating patients with clearly documented management plans.

To facilitate timely escalation to with Recognise and Respond Team and  for advice and support in managing the de