S CIEN C E Q U IZ
SILVERMAN
ANDERSEN
SCORING
Prepared by:
Romina Coronejo-Hoar,RN
Instructor II
IS S IL V E R M A N -
WHAT
N SC O R IN G ?
A N D E RS E
• The Silverman-Anderson Index, often referred to as
the Silverman Score, is a clinical tool used to assess
the severity of respiratory distress in newborns and
infants. It's commonly employed in neonatal
intensive care units (NICUs) to evaluate how a baby
is breathing. The score takes into account various
clinical signs, including chest retractions, nasal
flaring, grunting, and other indicators of respiratory
distress.
• A higher Silverman Score indicates more severe
respiratory distress. It can help healthcare
professionals determine the need for interventions
like oxygen therapy or mechanical ventilation in
newborns who may be struggling to breathe. The
score is a valuable tool for assessing and monitoring
the respiratory status of infants.
WH O DE V ELO PE D
M A N-A N DE RS EN
SILVER
SCORE ?
• Developed by Dr. Brian
Silverman and Dr. Ivan
Andersen in the 1950’s.
• Since then, it was integrated
in modern medicine and
widely used in neonatal care.
Shortly after the delivery of the baby, these
characteristics and qualities are assessed in
no fixed order.
1. Upper chest movement
2. Lower chest
retractions
3. Xiphoid retractions
4. Nasal flaring
5. Expiratory grunting
-AN D ERSO N
SILVERMAN
SCORE
-assess respiratory status only
1.Prepare your quiz notebook, pen, and nothing
else.
2.There will be 3 types of questions within the
quiz, and each type contains 3 questions.
3.Each question item will be flashed for 30–60
seconds before moving on to the next item.
4.Write your answers in your quiz notebook.
5.Ask your questions and get clarifications before
we start.
- A N D E R S E N
SILVERMAN
S C OR I N G
Upper chest movement (0-2
points):
• 0 point: Synchronised
movement
A • 1 point: Slight lag/delay
upon respiration
• 2 points: Abnormal see-
saw movement
C
D
-A ND E R SE N
SILVERMAN
SCORING
Lower chest retraction (0-2
points)
• 0 points: None
A
• 1 point: Just visible
B
• 2 points: Visible and
prominent
C
D Alveolus
-AND ERSEN
SILVERMAN
SCORING
Xiphoid Retractions (0-2 points):
• 0 points: None
A
1 point: Slightly visible
B
• 2 points: Visible and
prominent
C
D
AN -A N D ERSEN
SILVERM
SCORING
Nasal Flaring (0-2 points):
Nasal Flaring (0-2
points):
A • 1 point: Slightly
visible flaring
B
2 points: Easily seen
C and constant flaring.
D
N -A N DERSEN
SILVERMA
SCORING
Expiratory Grunting (0-2 points):
• 0 points: No grunting
A
• 1 point: Heard with a
stethoscope
B
• 2 points: Heard
C audibly by ear
D
-A N D ER S E N
SILVERMAN
S C O R I N G
Following the assessment through the scoring, it's essential to provide an
explanation or analysis of the total score.
Total Score of 0-2: A score in this range indicates that the
infant is not experiencing significant respiratory distress. They
1.
are breathing comfortably, and there are no apparent signs of
respiratory difficulty.
Total Score of 3-5: This range of scores signifies that the infant is
2. going through a mild to moderate level of respiratory distress. It
implies that the baby is having some trouble with breathing, but
the condition is not critical or severe.
Total Score of 6-10: A score of 6 or higher signifies
severe respiratory distress. Infants in this range are in
3. critical condition, experiencing significant difficulty in
breathing. Immediate medical intervention is necessary
to manage and treat the severe respiratory distress.
This may involve measures like oxygen therapy or even
mechanical ventilation.
