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Does the National Early Warning Score 2 system serve its purpose?

      The study by Pimental et al.
      • Pimental M.A.F.
      • Redfern O.C.
      • Gerry S.
      • Collins G.S.
      • et al.
      A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: a multi-centre database study.
      is important as it is the first to compare the ability of the National Early Warning Score (NEWS)
      • Hodgson L.E.
      • Dimitrov B.D.
      • Congleton J.
      • et al.
      A validation of the National Early Warning Score to predict outcome in patients with COPD exacerbation.
      • Schmidt P.E.
      • Meredith P.
      • Prytherch D.R.
      • et al.
      Impact of introducing an electronic physiological surveillance system on hospital mortality.
      with the National Early Warning Score 2 (NEWS2) to identify patients at risk of in hospital mortality, cardiac arrests and unplanned ICU admissions. Building upon the recommended and widely used NEWS system in UK hospitals and other parts of the world, NEWS2 introduced different weights at a lower SpO2 scale (i.e., <88–92%) in comparison to the SpO2 threshold <95% in the NEWS weights. NEWS2 also introduces new increasing weights for the use of supplemental oxygen at higher SpO2 level (e.g., >93–94%) to reflect the concern of hyperopia inducted hypercapnia respiratory failure for patients with/at risk of type II respiratory failure (T2RF). These changes in NEWS weight scheme keep in consistent with the current guideline for the T2RF patients.
      • O’Driscoll B.R.
      • Howard L.S.
      • Earis J.
      • et al.
      British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings.
      • Beasley R.
      • Chien J.
      • Douglas J.
      • et al.
      Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: ‘Swimming between the flags’.
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