Hi Neil and all, thanks for this post.
NEWS2 is part of a movement globally to recognise and manage critically ill patients which has gained momentum over the past 15 or 20 years. Having said that, it is still a largely neglected area, as the African Critical Illness Outcome Study (ACIOS https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02846-0/fulltext) revealed last year – 56% of critically ill patients in African hospitals do not receive the most basic life-saving treatments (oxygen, IV fluids, basic airway management).
There are several early warning scores for identifying critical illness such as NEWS2 that are used in different settings globally. Using single severely deranged vital signs can be a more feasible and useful approach in lower resource settings as it is quicker, simpler, and can be used to indicate the correct acute action needed to treat the problem. This is the approach used in Essential Emergency and Critical Care (EECC) (www.eeccglobal.org) and included in the EECC Vital Sign Directed Therapy protocol which has been implemented in Tanzania and elsewhere (https://www.eeccglobal.org/eecc-tools). Increasing the provision of EECC in health facilities throughout the world including the early identification and treatment of critical illness could avert a large number of unnecessary deaths each year.
Yours
Tim
Tim Baker
HIFA profile: Tim Baker is a physician and associate professor in global critical care. He is a member of faculty at Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and has positions at Karolinska Institutet in Sweden and QMUL and LSHTM in the UK. Tim’s interest is in evaluating and improving health services and health systems for the provision of good quality care to critically ill patients. tim.baker AT ki.se