A newborn with respiratory distress with RR 86/ min, nasal flaring, audible grunting, abdomen lagged behind chest respiratory movement, no lower chest or xiphoid retraction. What is silverman's score ?
Ans. is `c' i.e., 5 Assessment of respiratory depression The severity of respiratory distress is assessed by Silverman- Anderson score and Downes' score. While the Silverman Anderson Retraction Score is more suited for preterms with HMD, the Downes' score is more comprehensive and can be applied to any gestational age and condition. Silverman Anderson retraction score Score Upper chest Low chest Xiphoid Nasal Grunt retraction retraction retraction flaring Synchronized None None None None 1 Lag on inspiration Just visible Just visible Minimal Stethoscope only 2 See- saw Marked Marked Marked Naked ear o A score of >6 is indicative of impending respiratory failure o Now analyzing our question data :- i) Upper chest - Lag on inspiration present score 1 ii) Lower chest - No retraction --> score 0 iii) Xiphoid - No retraction --> score 0 iv) Nasal flaring - Present score 2 v) Grunting - Present score 2 o So, total score is 5. Downers's score Score Respiratory rate Cyanosis Air entry Grunt Retraction 0 < 60/min Nil Normal None Nil 1 60-80/train In room air Mild? Ausc with stethoscope Mild 2 >80/ min En >40% 02 Marked? Audible with naked ear Moderate o A score of > 6 is indicative of impending respiratory failure.
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