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


download 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

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Clinical Guidelines
This guideline has been approved by the Trust's Clinical Guidelines Assessment Panel as an aid to the diagnosis and management of relevant patients and clinical circumstances. Not every patient or situation fits neatly into a standard guideline scenario and the guideline must be interpreted and applied in practice in the light of prevailing clinical circumstances, the diagnostic and treatment options available and the professional judgement, knowledge and expertise of relevant clinicians. It is advised that the rationale for any departure from relevant guidance should be documented in the patient's case notes.
The Trust's guidelines are made publicly available as part of the collective endeavour to continuously improve the quality of healthcare through sharing medical experience and knowledge. The Trust accepts no responsibility for any misunderstanding or misapplication of this document.