Major Incident Planning and Support (MIP+S) Level 3

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NEWS2 and triage

Video 24 of 100
2 min 32 sec
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How does the NEWS2 system relate to triage?

So you understand, Mark, that we are doing this rapid assessment and triage, it involves obtaining the patient's observation to diagnostics, the blood pressure, the temperature, etcetera. When we have taken these and we populate them into the documentation platform, it will convert this to a NEWS2 score. The NEWS2 score is a predictive score, which will tell us how unwell that patient is at that time and certain parameters within the NEWS2 score will dictate what level of care that patient needs to move on to, so it is a good predictive score in the early triage of patients and the acuity of their presentation.

So what are the components of the NEWS score?

The physiological parameters within the NEWS2 score, the national early warning system score, is we are looking at the respiratory rate, we are looking at pulse rate, we are looking at pulse oximetry, we are looking at a conscious level, we are looking at blood pressure and we will also ask about pain scores as well. And we also need to know if the patient is on any supplemental oxygen, not many patients presenting at triage in ED will be on oxygen at that point. And what we need to be mindful of, Mark, is if in any one of those individual parameters, say, for example, respiratory rate, if their respiratory rate is excessively slow or excessively fast, that will give us a high score within that one parameter, which would be a 3, for example, with a respiratory rate above 30.

This in itself is a warning sign. If we then start getting high marks within another parameter, say, for example, blood pressure or pulse oximetry, this elevates the NEWS2 score, which will give us an earlier warning that this patient is likely to deteriorate, hence we need to make sure that this patient is pushed forward sooner.

The higher the score, the more sick the patient is.

There different stages where once they get a certain score, then they need to be in this particular area?

If a patient was scoring a NEWS score of 5 or above, that patient needs some urgent intervention, that would need some high dependency intervention, but if anybody is triggering an individual parameter score of 3, it is cause for concern straight away and they need to be seen urgently.