Downe's Score (Neonatal Respiratory Distress)
Total Downe's Score
0 / 10
Severity Classification
No Distress
Recommended Action
Supportive Care in Room Air
1. Cyanosis
2. Retractions
3. Expiratory Grunting
4. Air Entry
5. Respiratory Rate
Downe's Clinical Decision Pathway:
- Score 1–3 (Mild Distress): Supplemental oxygen via nasal cannula/hood, monitor SpO2, arterial blood gas.
- Score 4–6 (Moderate Distress): Nasal CPAP (5–7 cm H2O) or High-Flow Nasal Cannula (HFNC); chest X-ray; consider early surfactant.
- Score ≥ 7 (Severe Distress / Impending Respiratory Failure): Urgent Endotracheal Intubation, Mechanical Ventilation, Arterial Line, and Surfactant administration.