The National Early Warning Score (NEWS) of the National Health Service may not perform as well in patients with chronic hypoxemia. The Chronic Respiratory Early Warning Score (CREWS) uses a modification of one parameter (oxygen saturation) to improve its use in this population.
Patient selection: hospital inpatient adult with chronic lung disease
Parameters:
(1) heart rate in beats per minute
(2) systolic blood pressure in mm Hg
(3) respiratory rate in breaths per minute
(4) oxygen saturation in percent (values are 6 percent lower than in NEWS)
(5) consciousness level
(6) temperature
(7) any supplemental oxygen (must be prescribed)
Parameter
Finding
Points
heart rate
<= 40 beats per minute
3
41 to 50 beats per minute
1
51 to 90 beats per minute
0
91 to 110 beats per minute
1
111 to 130 beats per minute
2
>= 131
3
systolic blood pressure
<= 90 mm Hg
3
91 to 100 mm Hg
2
101 to 110 mm Hg
1
111 to 219 mm Hg
0
>= 220 mm Hg
3
respiratory rate
<= 8
3
9 to 11
1
12 to 20
0
21 to 24
2
>= 25
3
oxygen saturation
<= 85 percent
3
86-87 percent
2
88-89 percent
1
>= 90 percent
0
CNS status
alert
0
responds to voice
3
responds to pain
3
unresponsive to all stimuli
3
temperature
<= 35°C
3
35.1 to 36.0°C
1
36.1 to 38.0°C
0
38.1 to 39.0°C
1
>= 39.1°C
2
any supplemental oxygen
no
0
yes
2
CREWS score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the more serious the patient's condition.
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