Recognising deterioration

Early identification of infection and deterioration

Elderly individuals are more susceptible to infections due to their weaker immune system, increased comorbidity, and age-related decline in physiological functions. Early identification and treatment of infections in the elderly population are crucial to prevent serious complications, including sepsis and death. One tool that is widely used for early identification of infections is the National Early Warning Score 2 (NEWS2) score.

NEWS2 score

The NEWS2 score is a standardised clinical assessment tool that provides a numerical score based on vital signs and other physiological parameters to detect early clinical deterioration in patients. It consists of six physiological parameters: respiratory rate, oxygen saturation, systolic blood pressure, pulse rate, level of consciousness or new confusion, and temperature. Each parameter is assigned a score between 0 and 3, with higher scores indicating more severe abnormality. The total score is then calculated, and patients are assigned to one of three categories: low risk (0-4), medium risk (5-6), or high risk (≥7) of clinical deterioration.

The NEWS2 score is easy to use and can be quickly calculated at the bedside using routine observations. It provides a standardised approach to identifying early clinical deterioration and can facilitate early interventions, such as administration of antibiotics and fluids, which can prevent the progression of infection and reduce the risk of complications. It also allows for early escalation of care, including transfer to a higher level of care, if necessary.

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Page last reviewed: 19 September, 2023