NEWS

Question 1

what is the first sign of an MI

Answer 1

systolic BP drop <90 followed by a GCS drop or airway problem

Question 2

what are the news scores that classify the clinical risk of deterioration

Answer 2

aggregate 0-4
Low clinical risk
Ward-based response
Follow local protocol for response time

Any score <5 but one clinical paramter in the red (3)
Low-medium clinical risk
Urgent ward based response
‘urgent’ signifies the need for a member of staff with the appropriate competence in assessing acutely unwell patients and escalating if required
Follow local protocol for response time

Aggregate score 5-6
Medium clinical risk
Key threshold for urgent response
Should be seen in the hour by an approproatiately trained clinician

Aggregate score 7+  
High clinical risk  
Urgent/emergency response  
Must include a member of staff with critical care skills  including airway management  
Should be seen <30mins

Question 3

what are useful clinical parameters outside of a NEWS score that give information on clinically unwell patients

Answer 3

Cap refill
>2second = high risk for severe infection (early sign for sepsis) - particularly in children

Lactate
Indicates amount of anaerobic metabolism occuring
Gives a rough idea of perfusion
>2 = 5x increase in mortality

Urine output
Massive indicator for kidney health
Should be 0.5ml/kg/hr