INTRODUCING THE UKRN LIFE: NEWS2 CALCULATION

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This post introduces you to the UKRN life. One of the common things to start your prep is knowing the popular NEWS2 recording system. This post will expatiate on it and give you insights.

The National Early Warning Score (NEWS2) is a system used in the UK to quickly identify patients at risk of deterioration, particularly in hospital settings. It helps healthcare professionals to provide timely interventions, which can save lives. Here’s a straightforward guide to understanding and using NEWS2. When you get to the UK, you will learn this a lot so why not learn ahead now? There's no big deal about it.

What is NEWS2?

NEWS2 is a scoring system used to assess the severity of illness and monitor the condition of patients. It involves checking six physiological parameters and assigning a score based on how far these parameters deviate from normal ranges. In simple terms, it's a way that UK healthcare workers record their vital signs so that they can make sense of it using a scoring system.

The Six Parameters

1. Respiratory Rate (RR): How many breaths a patient takes per minute.

2. Oxygen Saturation (SpO2): The percentage of oxygen in the blood.

3. Systolic Blood Pressure (SBP):  The pressure in the arteries when the heart beats.

4. Heart Rate (HR): The number of heartbeats per minute.

5. Level of Consciousness (LOC): How awake and responsive a patient is, often measured using the AVPU scale (Alert, Voice, Pain, Unresponsive). There is also a ‘C’ for confusion but it is only meant for patient who have only suffered a NEW ONSET CONFUSION.

6. Temperature: The patient’s body temperature.

NEWS2 VIDEO

Link to video: https://youtu.be/Sse4FXJWx8w

 

CLICK HERE FOR A LINK TO THE NEWS2 CHART: CLICK ME

How to Calculate NEWS2

The first thing I want you to know is that there are two scales. We have  Scale 1 and 2 of NEWS2 specifically referring to the oxygen saturation (SpO2).

SpO2 Scale 1: This is the standard scale used for the majority of patients. It assesses oxygen saturation levels, aiming for a target saturation of 96-100%. Scores are assigned based on how far the patient’s SpO2 deviates from this range.

SpO2 Scale 2: This scale is used for patients with hypercapnic respiratory failure, typically associated with conditions like chronic obstructive pulmonary disease (COPD). For these patients, the target SpO2 is lower, around 88-92%, to avoid worsening their hypercapnia. The scoring system is adjusted accordingly to reflect these different target ranges. In short, scale 2 is indicated for patient who require adjusted oxygen saturation levels. In some hospitals, it requires a clear indication that patient is on scale 2 before scale 2 is used to record their observations.

NB: You can only use one scale at a time. You cannot use scale 1 and 2 on a particular time of assessment. 

Each parameter is measured and scored as follows using the colored chat:

- Respiratory Rate:

  - 12-20 breaths per minute = 0 points

  - 9-11 or 21-24 breaths per minute = 1 point

  - 25 or more breaths per minute = 3 points

- Oxygen Saturation (SpO2):

  - 96% or more = 0 points

  - 94-95% = 1 point

  - 92-93% = 2 points

  - 91% or less = 3 points

- Systolic Blood Pressure (SBP): (that is the only one that gives you a score on the chart, ignore the diastolic score)

- 220 and above = 3 points

  - 111-219 mmHg = 0 points

  - 101-110 mmHg = 1 point

  - 91-100 mmHg = 2 points

  - 90 mmHg or less = 3 points

- Heart Rate (HR):

  - 51-90 beats per minute = 0 points

  - 41-50 or 91-110 beats per minute = 1 point

  - 111-130 beats per minute = 2 points

  - 131 or more beats per minute = 3 points

- Level of Consciousness (LOC):

  - Alert = 0 points

  - Responds to Voice = 3 points

  - Responds to Pain = 3 points

  - Unresponsive = 3 points

- Temperature:

  - 36.1-38.0°C = 0 points

  - 35.1-36.0°C = 1 point

  - 38.1-39.0°C = 1 point

  - 35.0°C or lower = 3 points

  - 39.1°C or higher = 3 points

Using the NEWS2 Score

1. Calculate the total NEWS2 score by adding the points from each parameter.

2. Interpret the score:

   - 0-4: Low risk – Routine monitoring

   - 5-6: Medium risk – Increased frequency of observations and consider medical review.

   - 7 or more: High risk – Urgent review by a senior clinical decision-maker.

Practical Tips

- Documentation: Record the measurements accurately and regularly on the NEWS2 chart.

- Escalation: Follow the escalation protocol based on the score. If the score is high, inform the appropriate medical team immediately.

- Training: Familiarize yourself with the equipment used to measure each parameter and practice using it.

- Communication: Clearly communicate the NEWS2 score and the patient’s condition to other healthcare professionals during handovers or when seeking assistance.

Importance of NEWS2

- Early Detection: Helps in early identification of patient deterioration, enabling timely intervention.

- Standardization: Provides a standardized approach to patient monitoring across different healthcare settings.

- Improved Outcomes: Contributes to better patient outcomes by ensuring prompt treatment.

Let's fill the chart using this NEW2 chart:

Patient A: on scale 1

Respiratory rate: 22 breaths per minute

Oxygen saturation: 95%

Blood pressure: 135/65 mmHg

LOC = Alert

Heart rate: 88 beats per minute

Temperature: 37.1°C  

Solution: RR = 2 points; O2 sats equals 1 point. no scores for others: total 3 points

SAMPLE OF A FILLED NEWS2 CHART: CLICK ME

WHAT TO DO WITH THE SCORE:  CLICK ME

Take our quiz and stand the chance of an airtime: https://forms.gle/BAyUoH5q9d8R2ggq7

 

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