Newborn Transition Respiratory Scoring Tool
This respiratory scoring tool provides guidance to the delivery resuscitation teams caring for newborns at the University of Utah Hospital to help ensure the appropriate level of support for newborns with mild to moderate respiratory distress. The goals of this scoring tool include judicious use of continuous positive airway pressure (CPAP) to reduce iatrogenic complications (e.g., pneumothorax), allowing more neonates to transition with their mother, and preventing unnecessary admissions to the Neonatal Intensive Care Unit (NICU). The tool and care process were last updated in 2022.
Key Points
The tool applies to infants ages 35 weeks and older in the first 30 minutes of life with mild-to-moderate respiratory distress and equal breath sounds; apneic and non-vigorous infants and more premature infants are excluded. See Newborn Transition Care Guideline for more details.
Differs from APGAR
The elements of the tool differ from APGAR scoring in that they
focus entirely on indicators of respiratory distress (respiratory rate,
cyanosis, air entry, grunting, retractions, and nasal flaring).
Cut-off score
The tool uses a cut-off score of 4 or higher to prompt
initiation of CPAP; newborns with scores <4 should be observed
following normal transition protocols.
Transfer to NICU
Infants continuing to require CPAP after a total
10 minutes of effective CPAP should be transferred to the NICU
for care.
No transfer to NICU
Infants with improved respiratory scores
after a total of 10 minutes (or less) of CPAP can be
cared for in the Transition Nursery.
Documentation
Document use of the respiratory care
tool in the electronic medical record.
Resources
Information & Support
Related Portal Content
For Professionals
Transition Respiratory Scoring Tool PowerPoint (University of Utah)
An explanation of the University of Utah respiratory scoring tool, its background, and how to implement it in caring for newborns
with mild to moderate respiratory distress.
Services for Patients & Families Nationwide (NW)
| Service Categories | # of providers* in: | NW | Partner states (4) (show) | | NM | NV | RI | UT | |
|---|---|---|---|---|---|---|---|---|---|
| Pediatric Pulmonology | 4 | 4 | 6 | 3 | |||||
For services not listed above, browse our Services categories or search our database.
* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.