MCP๋กœ ์—ฐ๊ฒฐ โ†’

๊ณ„์‚ฐ ์ž…๋ ฅ

๊ณต์‹

๊ณต์‹: NEWS2 ์ ์ˆ˜ ๊ณ„์‚ฐ๊ธฐ

๊ด‘๊ณ 

๊ฒฐ๊ณผ

NEWS2 ์ด์ 
0
Clinical risk: Low
ํ•ญ๋ชฉ ํ•ญ๋ชฉ๋ณ„ ์ ์ˆ˜
ํ˜ธํก์ˆ˜ 0
SpO2 0
๋ณด์กฐ ์‚ฐ์†Œ 0
์ˆ˜์ถ•๊ธฐ ํ˜ˆ์•• 0
์‹ฌ๋ฐ•์ˆ˜ 0
์ฒด์˜จ 0
์˜์‹ ์ˆ˜์ค€ 0

NEWS2 ์ ์ˆ˜๋ž€?

๊ตญ๊ฐ€ ์กฐ๊ธฐ๊ฒฝ๋ณด์ ์ˆ˜ 2(National Early Warning Score 2, NEWS2)๋Š” ์˜๊ตญ NHS ์ „๋ฐ˜์—์„œ ์„ฑ์ธ ํ™˜์ž์˜ ๊ธ‰์„ฑ ์•…ํ™”๋ฅผ ํ‰๊ฐ€ํ•˜๊ณ  ์‹ ์†ํžˆ ๋Œ€์‘ํ•˜๊ธฐ ์œ„ํ•ด ์‚ฌ์šฉํ•˜๋Š” ํ‘œ์ค€ํ™”๋œ ๋„๊ตฌ์ž…๋‹ˆ๋‹ค. 6๊ฐ€์ง€ ์ƒ๋ฆฌํ•™์  ์ธก์ •๊ฐ’์— ๋ณด์กฐ ์‚ฐ์†Œ ํˆฌ์—ฌ ์—ฌ๋ถ€๋ฅผ ๋”ํ•ด ํ•˜๋‚˜์˜ ์ ์ˆ˜๋กœ ํ•ฉ์‚ฐํ•˜๋ฉฐ, ์ด ์ ์ˆ˜๋ฅผ ํ†ตํ•ด ํ™˜์ž์˜ ์ž„์ƒ์  ์•…ํ™”๋ฅผ ์กฐ๊ธฐ์— ๊ฐ์ง€ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ์ด ๊ณ„์‚ฐ๊ธฐ๋Š” ์˜๊ตญ ์™•๋ฆฝ์˜์‚ฌํšŒ(Royal College of Physicians)์˜ 2017๋…„ NEWS2 ๊ธฐ์ค€์„ ๋”ฐ๋ฅด๋ฉฐ, 16์„ธ ์ด์ƒ ์„ฑ์ธ์„ ๋Œ€์ƒ์œผ๋กœ ํ•ฉ๋‹ˆ๋‹ค. ์ž„์‚ฐ๋ถ€๋‚˜ ์†Œ์•„์—๊ฒŒ๋Š” ์ ์šฉ๋˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค. NEWS2๋Š” ์˜๊ตญ NHS ํ™˜๊ฒฝ์—์„œ ๋งŒ๋“ค์–ด์ง„ ๋„๊ตฌ์ด๋ฏ€๋กœ, ๋‹ค๋ฅธ ๋‚˜๋ผ์—์„œ๋Š” ์ž์ฒด ์กฐ๊ธฐ๊ฒฝ๋ณด ์‹œ์Šคํ…œ์ด๋‚˜ ์ž„์ƒ ๊ธฐ์ค€์ด ๋‹ค๋ฅผ ์ˆ˜ ์žˆ๋‹ค๋Š” ์ ์— ์œ ์˜ํ•˜์„ธ์š”.

6๊ฐ€์ง€ ํ™œ๋ ฅ์ง•ํ›„ ๋งค๊ฐœ๋ณ€์ˆ˜์™€ ์‚ฐ์†Œ๊ฐ€ ๋‹จ์ผ NEWS2 ์ ์ˆ˜๋กœ ํ†ตํ•ฉ๋˜๋Š” ๋ชจ์Šต
NEWS2์˜ 7๊ฐ€์ง€ ๋งค๊ฐœ๋ณ€์ˆ˜๊ฐ€ ๊ฒฐํ•ฉ๋˜์–ด ๋‹จ์ผ ์ข…ํ•ฉ ์กฐ๊ธฐ ๊ฒฝ๊ณ  ์ ์ˆ˜๊ฐ€ ๋ฉ๋‹ˆ๋‹ค.

์‚ฌ์šฉ ๋ฐฉ๋ฒ•

ํ™˜์ž์˜ ํ˜ธํก์ˆ˜, ์‚ฐ์†Œํฌํ™”๋„(๋Œ€๋ถ€๋ถ„์˜ ํ™˜์ž๋Š” SpO2 ์ฒ™๋„ 1์„ ์„ ํƒํ•˜๊ณ , ๊ณ ํƒ„์‚ฐํ˜ˆ์„ฑ ํ˜ธํก๋ถ€์ „ ์œ„ํ—˜์ด ์žˆ๋Š” ํ™˜์ž๋Š” ์ฒ™๋„ 2๋ฅผ ์„ ํƒ), ๋ณด์กฐ ์‚ฐ์†Œ ํˆฌ์—ฌ ์—ฌ๋ถ€, ์ˆ˜์ถ•๊ธฐ ํ˜ˆ์••, ์‹ฌ๋ฐ•์ˆ˜, ์ฒด์˜จ, ๊ทธ๋ฆฌ๊ณ  ACVPU ์ฒ™๋„์— ๋”ฐ๋ฅธ ์˜์‹ ์ˆ˜์ค€์„ ์ž…๋ ฅํ•˜์„ธ์š”. ์ž…๋ ฅ์ด ๋๋‚˜๋ฉด NEWS2 ์ด์ ๊ณผ ๊ฐ ํ•ญ๋ชฉ๋ณ„ ์ ์ˆ˜, ๊ทธ๋ฆฌ๊ณ  ์ž„์ƒ ์œ„ํ—˜ ๋“ฑ๊ธ‰์ด ํ‘œ์‹œ๋ฉ๋‹ˆ๋‹ค.

๊ณ„์‚ฐ ๊ณต์‹

์ ์ˆ˜ = 7๊ฐœ ํ•ญ๋ชฉ์˜ ํ•ญ๋ชฉ๋ณ„ ์ ์ˆ˜ ํ•ฉ๊ณ„ \( \sum (\text{sub-scores}) \).

$$\text{NEWS2} = S_{RR} + S_{SpO_2} + S_{O_2} + S_{SBP} + S_{HR} + S_{Temp} + S_{ACVPU}$$

๊ฐ ์ธก์ •๊ฐ’์€ 0~3์ ์— ํ•ด๋‹นํ•˜๋Š” ๊ตฌ๊ฐ„์œผ๋กœ ๋ถ„๋ฅ˜๋ฉ๋‹ˆ๋‹ค. ์‚ฐ์†Œ๋ฅผ ํˆฌ์—ฌ ์ค‘์ด๋ฉด 2์ ์ด ์ถ”๊ฐ€๋ฉ๋‹ˆ๋‹ค. ์˜์‹์ด ํ˜ผํƒํ•˜๊ฑฐ๋‚˜(ํ˜ผ๋ˆ), ์Œ์„ฑยทํ†ต์ฆ์—๋งŒ ๋ฐ˜์‘ํ•˜๊ฑฐ๋‚˜, ๋ฌด๋ฐ˜์‘์ธ ํ™˜์ž๋Š” ์˜์‹ ํ•ญ๋ชฉ์—์„œ 3์ ์„ ๋ฐ›์Šต๋‹ˆ๋‹ค. ์ด์ ์€ 0~20์  ๋ฒ”์œ„์ž…๋‹ˆ๋‹ค.

๊ด‘๊ณ 
์‹ฌ๊ฐ๋„๊ฐ€ ๋†’์•„์ง€๋Š” NEWS2 ์ด์ ์— ๋Œ€ํ•œ ์ƒ‰์ƒ์œผ๋กœ ๊ตฌ๋ถ„๋œ ์œ„ํ—˜ ๋“ฑ๊ธ‰
NEWS2 ์ด์ ์€ ๋‚ฎ์Œ, ๋‚ฎ์Œ-์ค‘๊ฐ„, ์ค‘๊ฐ„, ๋†’์Œ์˜ ์ž„์ƒ ์œ„ํ—˜ ๋“ฑ๊ธ‰์œผ๋กœ ๋ถ„๋ฅ˜๋ฉ๋‹ˆ๋‹ค.

๊ณ„์‚ฐ ์˜ˆ์‹œ

์‚ฐ์†Œ๋ฅผ ํˆฌ์—ฌ ์ค‘์ธ ํ™˜์ž๊ฐ€ ํ˜ธํก์ˆ˜ 28ํšŒ/๋ถ„(3์ ), ์ฒ™๋„ 1 ๊ธฐ์ค€ SpO2 90%(3์ ), ์‚ฐ์†Œ ํˆฌ์—ฌ ์˜ˆ(2์ ), ์ˆ˜์ถ•๊ธฐ ํ˜ˆ์•• 88mmHg(3์ ), ์‹ฌ๋ฐ•์ˆ˜ 35bpm(3์ ), ์ฒด์˜จ 34.5ยฐC(3์ ), ์ƒˆ๋กœ ๋ฐœ์ƒํ•œ ํ˜ผ๋ˆ(3์ )์ธ ๊ฒฝ์šฐ,

$$3+3+2+3+3+3+3 = 20$$

์ ์ด ๋ฉ๋‹ˆ๋‹ค. ์ด๋Š” ์ตœ๊ณ  ์ ์ˆ˜์ด๋ฉฐ ๊ธด๊ธ‰ ๊ณ ์œ„ํ—˜(High-risk) ๊ฒฝ๋ณด์— ํ•ด๋‹นํ•ฉ๋‹ˆ๋‹ค.

์ž์ฃผ ๋ฌป๋Š” ์งˆ๋ฌธ

์ตœ๊ณ  ์ ์ˆ˜๋Š” ๋ช‡ ์ ์ธ๊ฐ€์š”? 20์ ์ž…๋‹ˆ๋‹ค.

๋†’์€ ์ ์ˆ˜๋Š” ๋ฌด์—‡์„ ์˜๋ฏธํ•˜๋‚˜์š”? ์ด์  7์  ์ด์ƒ์€ ๊ณ ์œ„ํ—˜(High)์œผ๋กœ, ์‘๊ธ‰ ์ž„์ƒ ๋Œ€์‘์ด ํ•„์š”ํ•ฉ๋‹ˆ๋‹ค. 5~6์ ์€ ์ค‘์œ„ํ—˜(Medium), 0~4์ ์€ ์ €์œ„ํ—˜(Low)์ž…๋‹ˆ๋‹ค. ๋‹จ์ผ ํ•ญ๋ชฉ์—์„œ 3์ ์ด ๋‚˜์˜ค๋ฉด ์ด์ ์ด ๋‚ฎ๋”๋ผ๋„ ์ฆ‰๊ฐ์ ์ธ ์žฌํ‰๊ฐ€๊ฐ€ ํ•„์š”ํ•ฉ๋‹ˆ๋‹ค.

์ฒ™๋„ 1๊ณผ ์ฒ™๋„ 2 ์ค‘ ๋ฌด์—‡์„ ์„ ํƒํ•ด์•ผ ํ•˜๋‚˜์š”? ์ฒ™๋„ 2๋Š” ๋ชฉํ‘œ ์‚ฐ์†Œํฌํ™”๋„ ๋ฒ”์œ„๊ฐ€ 88~92%์ธ ํ™•์ง„๋œ ๊ณ ํƒ„์‚ฐํ˜ˆ์„ฑ ํ˜ธํก๋ถ€์ „ ํ™˜์ž(์˜ˆ: ์ผ๋ถ€ COPD ํ™˜์ž)์—๊ฒŒ๋งŒ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค. ๊ทธ ์™ธ ๋ชจ๋“  ํ™˜์ž๋Š” ์ฒ™๋„ 1์„ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค.

์ตœ์ข… ์—…๋ฐ์ดํŠธ: