NATIONAL EARLY WARNING SCORE (NEWS)

The difficulty in spotting that flu-like symptoms are actually sepsis was one of the reasons that led to the development of the National Early Warning Score (NEWS and NEWS2) for the detection of deteriorating patients, a measure which has been widely implemented to improve patient safety in the NHS.

Professor Bryan Williams is chair of medicine at University College London (UCL), and clinical lead for the Royal College of Physicians team that led the NEWS development. He says: “Sepsis doesn’t have a single type of presentation and that’s one of the reasons it can be so dangerous and recognition can be delayed.”

He explains that in NHS hospitals, doctors and nurses are encouraged to review patients’ NEWS2 score, which is based on routine vital signs measurements such as heart rate, temperature, respiratory rate, oxygen levels etc. If the score is five or more, medics should consider whether sepsis could be causing the illness, and the patient should be reviewed urgently by an experienced clinician, he stresses.

“If the patient has risk factors for sepsis such as evidence of infection, a skin rash, is immune compromised or has a wound that might be a source of infection, then this strengthens the likelihood of sepsis,” he says.

“Nevertheless, even in the absence of such indicators, this NEWS2 warning system is an important tool to alert medical staff that the patient is acutely ill and may have sepsis as an underlying cause.”