4 Silverman- Anderson Score is used to assess the degree of respiratory distress in newborn (usually with Respiratory Distress Syndrome). -The index involves observation of five features, each of which is scored as 0, 1 or 2. - The higher the score, the greater the respiratory distress. - A score over 7 sueeests severe respiratory distress. _ . Silverman -- Anderson Index Score Upper Chest Retraction Lower Chest Retraction Xiphoid Retraction Nares flaring Grunt 0 Chest and abdomen rise together Nostals Interco retractions No Xiphoid retractions No nasal Flaring No expiratory Bunt 1. Lag or minimal sinking of upper chest as abdomen rises Minimal intercostals retractions Minimal xiphoid retractions Minimal nasal fairing Expiratory grunt heard with stethoscope 7, Upper chest and abdomen move as a see-saw" Marked intercostals retractions Marked xiphoid retractions Marked nasal flaring Audible expiratory grunt Now look at the values in the question * Upper chest Lag on inspiration present --> Score 1 * Lower chest --> Slight retraction present Score 1 * Xiphoid retraction Not present ---> Score 0 * Nares flaring --> Not present --> Score 0 * Grunting -4 Audible grunting Score 2 Total = Score 4 - The Downes' score is more comprehensive and can be applied to any gestational age and condition Score Respiratory rate Cyanosis Air entry Grunt Retraction 0 < 60/min Nil Normal None Nil i 60-80 In room air Mild Auscult with stethoscope Mild 2 >80/min In 40% 0, Marked Audible with naked air Moderate