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The midwife should evaluate the newborn according to Silverman Respiratory Scale.
Silverman Retraction Scores (Evaluation of Respiratory Status):
Feature Observed Score 0 Score 1 Score 2 Score Chest Movement Synchronized Respiration Lag on Respirations Seesaw Respirations Intercostal Retractions None Just Visible Marked Xiphoid Retractions None Just Visible Marked Nares Dilation None Minimal Marked Expiratory Grunt None Audible With Stethoscope Audible With Unaided Ear
Total Score of 0 indicates no respiratory distress.
Total Score of 4-6 indicates moderated distress.
Total Score of 7-10 indicates severe distress.Total
Silverman
Score
Monitor and observe closely while administering complimentary therapies.
Increase room temperature; be particularly cautious concerning thermo-regulation of the newborn.
Continue to monitor until baby has stabilized or the need to transfer is apparent.
The midwife should recommend to the client that early pediatric evaluation may need to be done.
Variations of Postpartum
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