Silverman Anderson Score (SAS) are widely used for the categorization of respiratory distress in neonates. It consists of five items: (1) chest retraction as compared with abdominal retraction during inhalation; (2) retraction of the lower intercostal muscles; (3) xiphoid retraction; (4) flaring of the nares with inhalation; and (5) grunting on exhalation. Chest movement- synchronized(0) vs. minimal lag(1) or sinking of the upper chest as the abdomen rises. In the most extreme instances, a seesaw-like movement of the chest and abdomen is observed and would be given a score of 2. Intercostal retractions- retraction between the ribs is rated as none(0), minimal(1)or marked(2). Xiphoid retractions- retraction below the xiphoid process are rated as none(0), minimal(1) or marked(2). Nasal flaring- no nasal flaring: 0. Minimal flaring is scored 1 and marked flaring is scored 2. Expiratory grunting- no grunting: 0, grunting that is audible with a stethoscope is scored 1, and grunting that is audible without using a stethoscope is scored 2. Adequate ventilation is indicated by a 0, severe respiratory distress is indicated by a score of 10. Reference: GHAI Essential pediatrics, 8th edition