{ "meta": { "title": "NPEWS scoring — canonical machine-readable specification", "source": "Configuration Document for SPOT NPEWS (NHS England)", "verified": "Manually checked against the live NHS England NPEWS charts by Marcus Baw (GMC 4712729) on 2026-06-30.", "note": "THIS FILE IS THE SINGLE SOURCE OF TRUTH for NPEWS numeric scoring. Edit this file, then run `npm run generate:scoring` to regenerate chart/npews-scoring-config.js (the runtime bands) and spec/npews-scoring-tables.generated.md (the human-readable unified table). Do not hand-edit the generated regions. The clinical narrative (respiratory-distress descriptors, review annotations) lives in spec/npews-scoring.md.", "conformance": "Conformant with the national SPOT NPEWS algorithm: temperature and AVPU are NOT numerically scored — temperature produces a sepsis warning and AVPU produces a specific-concern escalation decision (see nonScoring below)." }, "scoreColors": { "0": "white", "1": "yellow", "2": "orange", "4": "pink" }, "sentinels": { "comment": "Open-ended top bands use these as an inclusive max so the bands form a closed, machine-comparable set.", "rate": 999, "percent": 100, "litresPerMin": 20 }, "ageBands": ["0-11m", "1-4y", "5-12y", "13+y"], "comment_ageBandBounds": "Canonical age-in-years bounds per band, as half-open intervals [minAgeYears, maxAgeYears). The upper bound is EXCLUSIVE; null means open-ended. All boundaries fall on an exact birthday (1st, 5th, 13th), so band selection uses calendar completed-years (see chart/age-band.js) rather than a 365.25-day approximation. This is the single source of truth for which chart applies at a given age.", "ageBandBounds": { "0-11m": { "minAgeYears": 0, "maxAgeYears": 1 }, "1-4y": { "minAgeYears": 1, "maxAgeYears": 5 }, "5-12y": { "minAgeYears": 5, "maxAgeYears": 13 }, "13+y": { "minAgeYears": 13, "maxAgeYears": null } }, "ageBandDisplay": { "0-11m": { "label": "0 to 11 months", "headerColor": "#FFB6C1" }, "1-4y": { "label": "1-4 Years", "headerColor": "#FFA500" }, "5-12y": { "label": "5-12 Years", "headerColor": "#FFFF00" }, "13+y": { "label": "\u226513 Years", "headerColor": "#A9A9A9" } }, "comment_bands": "Every band is [min, max, score]. Bands are inclusive of both ends; consecutive bands meet at x.99 boundaries by design. SpO2 and oxygen-delivery bands are identical across all age bands and are defined once under `shared`.", "shared": { "oxygenSaturation": [ [0, 91, 4], [91.01, 94.99, 1], [95, 100, 0] ], "oxygenDeliveryPercent": [ [0, 15.99, 0], [16, 29.99, 1], [30, 49.99, 2], [50, 100, 4] ], "oxygenDeliveryLpm": [ [0, 0.009, 0], [0.01, 1.99, 1], [2, 5.99, 2], [6, 20, 4] ] }, "vitals": { "0-11m": { "respiratoryRate": [ [0, 9.99, 4], [10, 19.99, 2], [20, 29.99, 1], [30, 49.99, 0], [50, 59.99, 1], [60, 69.99, 2], [70, 999, 4] ], "heartRate": [ [0, 79.99, 4], [80, 89.99, 2], [90, 109.99, 1], [110, 149.99, 0], [150, 169.99, 1], [170, 179.99, 2], [180, 999, 4] ], "bloodPressureSystolic": [ [0, 49.99, 4], [50, 59.99, 2], [60, 69.99, 1], [70, 89.99, 0], [90, 99.99, 1], [100, 109.99, 2], [110, 999, 4] ] }, "1-4y": { "respiratoryRate": [ [0, 9.99, 4], [10, 19.99, 2], [20, 39.99, 0], [40, 49.99, 1], [50, 59.99, 2], [60, 999, 4] ], "heartRate": [ [0, 59.99, 4], [60, 69.99, 2], [70, 89.99, 1], [90, 139.99, 0], [140, 149.99, 1], [150, 169.99, 2], [170, 999, 4] ], "bloodPressureSystolic": [ [0, 49.99, 4], [50, 59.99, 2], [60, 79.99, 1], [80, 99.99, 0], [100, 119.99, 1], [120, 129.99, 2], [130, 999, 4] ] }, "5-12y": { "respiratoryRate": [ [0, 9.99, 4], [10, 14.99, 2], [15, 19.99, 1], [20, 24.99, 0], [25, 39.99, 1], [40, 49.99, 2], [50, 999, 4] ], "heartRate": [ [0, 59.99, 4], [60, 69.99, 2], [70, 79.99, 1], [80, 119.99, 0], [120, 139.99, 1], [140, 159.99, 2], [160, 999, 4] ], "bloodPressureSystolic": [ [0, 69.99, 4], [70, 79.99, 2], [80, 89.99, 1], [90, 109.99, 0], [110, 119.99, 1], [120, 129.99, 2], [130, 999, 4] ] }, "13+y": { "respiratoryRate": [ [0, 9.99, 4], [10, 14.99, 1], [15, 24.99, 0], [25, 29.99, 1], [30, 39.99, 2], [40, 999, 4] ], "heartRate": [ [0, 49.99, 4], [50, 59.99, 2], [60, 69.99, 1], [70, 99.99, 0], [100, 119.99, 1], [120, 129.99, 2], [130, 999, 4] ], "bloodPressureSystolic": [ [0, 79.99, 4], [80, 89.99, 2], [90, 99.99, 1], [100, 119.99, 0], [120, 129.99, 1], [130, 139.99, 2], [140, 999, 4] ] } }, "categorical": { "respiratoryDistress": { "none": 0, "mild": 1, "moderate": 2, "severe": 4 }, "capillaryRefill": { "thresholdSeconds": 3, "score": 2, "note": "Below/equal 2s scores 0; >=3s scores 2. Charts do not define a score for 2.01-2.99s." }, "oxygen": { "highFlowDevices": ["HF", "BiP", "CP"], "highFlowScore": 4, "levelDevices": ["NP", "FM", "HB", "NRB"], "note": "High-flow devices (High Flow, BiPAP, CPAP) override with score 4. Level devices score per the oxygenDeliveryPercent / oxygenDeliveryLpm bands." } }, "nonScoring": { "comment": "Per the national SPOT NPEWS Configuration Document these parameters do NOT contribute numeric points. Temperature produces a sepsis warning; AVPU produces a specific-concern escalation decision.", "temperature": { "role": "Think sepsis warning; does not independently assign an escalation level", "triggers": { "high": ">= 38", "low": "< 36" }, "display": { "hotZoneFrom": 38, "coldZoneTo": 36 } }, "avpu": { "role": "Specific-concern escalation trigger", "triggers": { "V": "high", "P": "emergency", "U": "emergency" } } }, "escalation": { "comment": "PEWS total to escalation level. Reference only — the runtime escalation thresholds live in npews-scorer.js and the display metadata in npews-scoring-config.js (ESCALATION_META).", "levels": [ { "level": "low", "min": 1, "max": 4, "label": "Low" }, { "level": "medium", "min": 5, "max": 8, "label": "Medium" }, { "level": "high", "min": 9, "max": 12, "label": "High" }, { "level": "emergency", "min": 13, "max": null, "label": "Emergency" } ] } }