Clinical exam · General exam and vital signs
Early warning scores: NEWS2 and qSOFA !
- Topic
Simple scores built from vital signs that help spot the deteriorating patient in time.
Updated 2026-11-01
What it is
Early warning scores turn vital signs into a score that signals the risk of deterioration and when to call for help. NEWS2, from the Royal College of Physicians, adds points for respiratory rate, saturation, supplemental oxygen, systolic pressure, pulse, consciousness and temperature. qSOFA, linked to the Sepsis-3 definition, uses three bedside criteria in patients with suspected infection. Neither replaces clinical judgement.
Key facts
- NEWS2: 0 to 4 low risk; 5 to 6 medium risk; 7 or more high risk.
- qSOFA: one point for each criterion, 0 to 3.
Step by step
- Take a full set of vital signs: respiratory rate, SpO2, oxygen, systolic pressure, pulse, consciousness and temperature.
- Assess consciousness with ACVPU: alert, new confusion, responds to voice, responds to pain or unresponsive.
- Assign each parameter's points from the official NEWS2 chart and add them up.
- Use NEWS2 SpO2 scale 2 only for patients with documented hypercapnic respiratory failure.
- In suspected infection, check the three qSOFA criteria.
- Escalate by score and local protocol, and record the time of the call.
qSOFA: one point per criterion
| Criterion | Cut-off |
|---|---|
| Respiratory rate | 22 per minute or more |
| Mental status | Altered (Glasgow below 15) |
| Systolic pressure | 100 mmHg or less |
Test yourself
Think of the answer, then tap the question to see it.
Which three criteria make up qSOFA?
Respiratory rate of 22 or more per minute, altered mentation and systolic pressure of 100 mmHg or less.
How many NEWS2 points does supplemental oxygen add?
Two points, added to those for saturation.
Which NEWS2 score calls for an emergency response?
A total of 7 or more.
Does a qSOFA of 0 or 1 rule out sepsis?
No; qSOFA picks out patients at higher risk of a poor outcome, but a low score does not exclude sepsis.
Related
- Vital signs: what they are and how to record them
- Fever, infection and sepsis: the bedside signs
- Level of consciousness and the Glasgow Coma Scale
- Pulse oximetry
Related conditions
Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.
Sources: National Early Warning Score (NEWS) 2 (Royal College of Physicians, 2017); Sepsis and Septic Shock - Critical Care Medicine - MSD Manual Professional Edition (Merck & Co. (MSD Manual Professional Edition), 2025); 15.3 Vital Signs - Clinical Nursing Skills | OpenStax (OpenStax, Rice University, 2024).
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Representative model, for educational purposes only.