Modified_Finnegan_Neonatal_Abstinence_Score v.0
Modified finnegan neonatal abstinence score will be used in order to provide an objective way to identify and categorize infants with NAS. References: Finnegan LP. Neonatal abstinence syndrome: assessment and pharmacotherapy. In: Nelson N, editor. Current therapy in neonatal-perinatal medicine. 2 ed. Ontario: BC Decker. 1990:262–70.
Stratifies severity of opioid withdrawal in newborns.
The NAS should be monitored over time; protocols for management based on scoring may differ by institution but some studies suggest monitoring every 3-4 hours. FORMULA Addition of the selected points: Central nervous system disturbances Cry: normal=0, Excessive high-pitched cry <5 minutes=2,Continuous high-pitched cry >5 minutes. Sleep:Normal=0, Sleeps <3 hours after feeding=1,Sleeps <2 hours after feeding=2,Sleeps <1 hour after feeding=3. Moro reflex: Normal=0, Hyperactive=2, Markedly hyperactive=3. Tremors: None=0, Mild tremors when disturbed=1,Moderate-severe tremors when disturbed=2, Mild tremors when undisturbed=3, Moderate-severe tremors when undisturbed=4. Increased muscle tone: no=0, yes=1. Excoriation (e.g. chin, knees, elbow, toes, nose): no=0, yes=1. Myoclonic jerks (twitching/jerking of limbs): no=0, yes=3. Myoclonic jerks (twitching/jerking of limbs): no=0, yes=5. Metabolism, vasomotor, and respiratory disturbances Sweating: no=0, yes=1. Hyperthermia: none=0, 37.2-38.3ºC (99.0-100.9ºF)=1, >38.3ºC (>100.9ºF)=2. Frequent yawning (>3-4 times per scoring interval): no=0, yes=1. Mottling: no=0, yes=1. Nasal stuffiness: no=0, yes=1. Sneezing (>3-4 times per scoring interval): no=0, yes=1. Nasal flaring: no=0, yes=2. Respiratory rate: normal=0, >60 breaths/minute, no retractions=1, >60 breaths/minute with retractions=2. Gastrointestinal disturbances Excessive sucking: no=0, yes=1. Poor feeding (infrequent/uncoordinated suck): no=0, yes=2. Regurgitation:no=0, ≥2 times during/post feeding=2. Projectile vomiting: no=0, yes=3. Stools: normal=0,Loose (curds/seedy)=2, Watery (water ring on diaper around stool)=3.
Cannot be used in infants without opoid exposure.
Finnegan LP. Neonatal abstinence syndrome: assessment and pharmacotherapy. In: Nelson N, editor. Current therapy in neonatal-perinatal medicine. 2 ed. Ontario: BC Decker. 1990:262–70.
OBSERVATION.modified_finnegan_neonatal_abstinence_score_nas.v0, EVALUATION.modified_finnegan_neonatal_abstinence_score_nas.v0
