Downes score calculator
Bedside scoring tool for newborn respiratory distress using five clinical observations.
Clinical disclaimer
How the score works
The Downes score assigns 0-2 points across five domains. Total scores range from 0 to 10; higher scores indicate more severe respiratory distress.
- Cyanosis and air entry reflect oxygenation and ventilation.
- Retractions and grunting describe work of breathing.
- Respiratory rate reflects tachypnea or apnea.
Interpretation
- 0: no distress.
- 1-3: mild distress.
- 4-6: moderate distress.
- 7-10: severe distress; consider escalation of support.
Trend scores over time and reassess after interventions.
Clinical notes
- Prematurity, sedation, or fatigue can blunt visible signs.
- Combine with oxygen saturation, blood gases, and overall appearance.
- Scores are helpful for trending but do not replace clinician assessment.
Related calculators
References
Frequently asked questions
It grades neonatal respiratory distress using cyanosis, retractions, grunting, air entry, and respiratory rate. Higher scores indicate more severe distress.
Scores of 0 indicate no distress, 1-3 mild, 4-6 moderate, and 7-10 severe respiratory distress. Always follow local protocols.
Downes scoring is used across gestational ages, but clinical context matters. Prematurity, sedation, or fatigue can affect findings.
No. It is a structured bedside tool to complement vital signs, oxygenation, and clinician judgment.