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Protocol - Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS)

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Description

The Finnegan Neonatal Abstinence Score Tool (FNAST) 2019 Final is 31-line score sheet measuring 21 symptoms that are frequently observed in opiate-exposed infants. These are measured by presence/abstinence or severity at various time intervals.

Specific Instructions

The neonatal abstinence syndrome scoring system was designed for term babies on 4-hourly feeds and may therefore need modification for preterm infants. In a term infant, scoring should be performed 30 minutes to 1 hour after a feed, before the baby falls asleep. If necessary, the infant should be awakened to elicit reflexes and behavior, but if the infant is woken to be scored, then diminished sleep after scoring should not be recorded. A crying infant should be soothed and quietened before assessing muscle tone, Moro reflex, and respiratory rate.

The 2010 Modified Neonatal Abstinence Syndrome Tool by Dr. Karen D'Apolito is a manual for instructions for evaluators that can be purchased for $120.00 for the cost of printing and mailing.

Protocol

Finnegan Neonatal Abstinence Scoring Toll (FNAST)

Patient ID:                Name:                 Today’s Weight:                 DOB:                 Date:

Signs and Symptoms

Score

AM

PM

Comments

Central Nervous System Disturbances

Crying: Excessive High Pitched

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Crying: Cont. High Pitched

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Sleep < 1 Hr After Feeding

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Sleep < 2 Hr After Feeding

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Sleep < 3 Hr After Feeding

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Hyperactive Moro reflex

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Markedly Hyperactive Moro reflex

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Mild Tremors: Disturbed

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Mod-Severe Tremors: Disturbed

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Mild Tremors: Undisturbed

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Mod-Severe Tremors: Undisturbed

4

 

 

 

 

 

 

 

 

 

 

 

 

 

Increased muscle tone

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Excoriation (Specific Area)

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Myoclonic jerk

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Generalized convulsions

5

 

 

 

 

 

 

 

 

 

 

 

 

 

Metabolic, Vasomotor And Respiratory Disturbance

Sweating

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Fever < 101 (37.2-38.3C)

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Fever > 101 (38.4C)

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Frequent yawning (> 3)

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Mottling

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Nasal stuffiness

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Sneezing (> 3)

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Nasal flaring

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Respiratory rate (> 60/min)

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Respiratory rate (> 60/min with retractions)

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Gastrointestinal Disturbances

Excessive sucking

1

 

 

 

 

 

 

 

 

 

 

 

 

 

Poor feeding

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Regurgitation

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Projectile vomiting

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Loose stools

2

 

 

 

 

 

 

 

 

 

 

 

 

 

Watery stools

3

 

 

 

 

 

 

 

 

 

 

 

 

 

Score

Total Score

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average Daily Score

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Inter-Observer Reliability %

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Initials of Scorer 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Initials of Scorer 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The FINNEGAN NEONATAL ABSTINENCE SCORE TOOL (FNAST) is for the assessment of infants exposed in utero to psychoactive drugs, particularly opioids/opiates. The evaluator should check signs observed at various time intervals and add the scores to obtain a total score. Observation of the scores over the time interval provides the progression/diminution of signs and the need for pharmacotherapy. Copyright, 2007.

The evaluator needs to be trained to administer the score and inter-rater reliability needs to assessed intermittently.

Availability

Available

Personnel and Training Required

Clinically trained staff

Equipment Needs

Thermometer and stopwatch/clock with a second hand

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training Yes
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Clinical Examination

Life Stage

Infant

Participants

Hospitalized full-term newborns

Selection Rationale

This protocol was selected for its shorter implementation time and the fact that it is used extensively in clinical settings.

Language

English

Standards
StandardNameIDSource
caDSR Common Data Elements (CDE) Pediatric Finnegan Neonatal Abstinence Score Tool (FNAST) Assessment Score   7051599 CDE Browser
Derived Variables

None

Process and Review

Not applicable

Protocol Name from Source

Finnegan Neonatal Abstinence Score Tool (FNAST) 2019 Final

Source

D’Apolito, K., & Finnegan, L. (2010). Assessing signs and symptoms of neonatal abstinence using the Finnegan Scoring Tool: An inter-observer reliability program. Neo Advances. http://www.neoadvances.com

Finnegan, L. P., Connaughton, J. F., Jr., Kron, R. E., & Emich, J. P.(1975). Neonatal abstinence syndrome: Assessment and management. Addictive Diseases, 2(1–2), 141–158.

General References

Finnegan, L. P. (1990). Neonatal abstinence syndrome: Assessment and pharmacotherapy. In N. Nelson (Ed.), Current therapy in neonatal-perinatal medicine (2nd ed, p. 317). Ontario, Canada: B. C. Decker.

Finnegan, L. P., & Kaltenbach, K. (1992). Neonatal abstinence syndrome. In R. A. Hoekelman, S. B. Friedman, N. Nelson, & H. M. Seidel (Eds.), Primary pediatric care (2nd ed., pp. 1367–1378.). St Louis, MO: C. V. Mosby.

Hudak, M. L., Tan, R. C., AAP Committee on Drugs, & AAP Committee on Fetus and Newborn. (2012). Neonatal drug withdrawal. Pediatrics, 129(2), e540–560.

Jansson, L. M., Velez, M., & Harrow, C. (2009). The opioid-exposed newborn: Assessment and pharmacologic management. Journal of Opioid Management, 5(1), 47–55.

Lester, B. M., Tronick, E. Z., & Brazelton, T. B. (2004). The Neonatal Intensive Care Unit Network Neurobehavioral Scale procedures. Pediatrics, 113(3 Pt. 2), 641–667.  

Royal Women’s Hospital Drug Information Centre, Newborn Emergency Transport Service (Victoria). (2004). Neonatal handbook. Carlton, Victoria, Australia: Author.

Sanlorenzo, L. A., Start, A. R., & Patrick, S. W. (2018). Neonatal Abstinence Syndrome: An update. Current Opinions in Pediatrics, 30(2), 182–186.

Wachman, E. M., Schiff, D. M., & Silverstein, M. (2018). Neonatal Abstinence Syndrome: Advances in diagnosis and treatment. JAMA, 319(13), 1362–1374.

Weiner, S. M., & Finnegan, L. P. (2015). Drug withdrawal in the neonate. In B. Carter & S. Gardner (Eds.), Mosby handbook of neonatal intensive care (8th ed.). Year Book, Inc.

Protocol ID

300701

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Crying_Cont_High_Pitched_AM
PX300701020100 Do you observe the following Central Nervous more
System Disturbances? Crying: Cont. High Pitched (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Crying_Cont_High_Pitched_Comments
PX300701020300 Do you observe the following Central Nervous more
System Disturbances? Crying: Cont. High Pitched - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Crying_Cont_High_Pitched_PM
PX300701020200 Do you observe the following Central Nervous more
System Disturbances? Crying: Cont. High Pitched (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Crying_Excessive_High_Pitched_AM
PX300701010100 Do you observe the following Central Nervous more
System Disturbances? Crying: Excessive High Pitched (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Crying_Excessive_High_Pitched_Comments
PX300701010300 Do you observe the following Central Nervous more
System Disturbances? Crying: Excessive High Pitched - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Crying_Excessive_High_Pitched_PM
PX300701010200 Do you observe the following Central Nervous more
System Disturbances? Crying: Excessive High Pitched (PM) show less
Variable Mapping
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Excoriation_Specific_Area_AM
PX300701130100 Do you observe the following Central Nervous more
System Disturbances? Excoriation (Specific Area) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Excoriation_Specific_Area_Comments
PX300701130300 Do you observe the following Central Nervous more
System Disturbances? Excoriation (Specific Area) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Excoriation_Specific_Area_PM
PX300701130200 Do you observe the following Central Nervous more
System Disturbances? Excoriation (Specific Area) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Generalized_Convulsions_AM
PX300701150100 Do you observe the following Central Nervous more
System Disturbances? Generalized convulsions (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Generalized_Convulsions_Comments
PX300701150300 Do you observe the following Central Nervous more
System Disturbances? Generalized convulsions - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Generalized_Convulsions_PM
PX300701150200 Do you observe the following Central Nervous more
System Disturbances? Generalized convulsions (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Hyperactive_Moro_Reflex_AM
PX300701060100 Do you observe the following Central Nervous more
System Disturbances? Hyperactive Moro reflex (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Hyperactive_Moro_Reflex_Comments
PX300701060300 Do you observe the following Central Nervous more
System Disturbances? Hyperactive Moro reflex - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Hyperactive_Moro_Reflex_PM
PX300701060200 Do you observe the following Central Nervous more
System Disturbances? Hyperactive Moro reflex (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Increased_Muscle_Tone_AM
PX300701120100 Do you observe the following Central Nervous more
System Disturbances? Increased muscle tone (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Increased_Muscle_Tone_Comments
PX300701120300 Do you observe the following Central Nervous more
System Disturbances? Increased muscle tone - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Increased_Muscle_Tone_PM
PX300701120200 Do you observe the following Central Nervous more
System Disturbances? Increased muscle tone (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Markedly_Hyperactive_Moro_Reflex_AM
PX300701070100 Do you observe the following Central Nervous more
System Disturbances? Markedly Hyperactive Moro reflex (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Markedly_Hyperactive_Moro_Reflex_Comments
PX300701070300 Do you observe the following Central Nervous more
System Disturbances? Markedly Hyperactive Moro reflex - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Markedly_Hyperactive_Moro_Reflex_PM
PX300701070200 Do you observe the following Central Nervous more
System Disturbances? Markedly Hyperactive Moro reflex (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mild_Tremors_Disturbed_AM
PX300701080100 Do you observe the following Central Nervous more
System Disturbances? Mild Tremors: Disturbed (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mild_Tremors_Disturbed_Comments
PX300701080300 Do you observe the following Central Nervous more
System Disturbances? Mild Tremors: Disturbed - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mild_Tremors_Disturbed_PM
PX300701080200 Do you observe the following Central Nervous more
System Disturbances? Mild Tremors: Disturbed (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mild_Tremors_Undisturbed_AM
PX300701100100 Do you observe the following Central Nervous more
System Disturbances? Mild Tremors: Undisturbed (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mild_Tremors_Undisturbed_Comments
PX300701100300 Do you observe the following Central Nervous more
System Disturbances? Mild Tremors: Undisturbed - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mild_Tremors_Undisturbed_PM
PX300701100200 Do you observe the following Central Nervous more
System Disturbances? Mild Tremors: Undisturbed (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mod_Severe_Tremors_Disturbed_AM
PX300701090100 Do you observe the following Central Nervous more
System Disturbances? Mod-Severe Tremors: Disturbed (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mod_Severe_Tremors_Disturbed_Comments
PX300701090300 Do you observe the following Central Nervous more
System Disturbances? Mod-Severe Tremors: Disturbed - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mod_Severe_Tremors_Disturbed_PM
PX300701090200 Do you observe the following Central Nervous more
System Disturbances? Mod-Severe Tremors: Disturbed (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mod_Severe_Tremors_Undisturbed_AM
PX300701110100 Do you observe the following Central Nervous more
System Disturbances? Mod-Severe Tremors: Undisturbed (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mod_Severe_Tremors_Undisturbed_Comments
PX300701110300 Do you observe the following Central Nervous more
System Disturbances? Mod-Severe Tremors: Undisturbed - Comments: show less
Variable Mapping
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Mod_Severe_Tremors_Undisturbed_PM
PX300701110200 Do you observe the following Central Nervous more
System Disturbances? Mod-Severe Tremors: Undisturbed (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Myoclonic_Jerk_AM
PX300701140100 Do you observe the following Central Nervous more
System Disturbances? Myoclonic jerk (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Myoclonic_Jerk_Comments
PX300701140300 Do you observe the following Central Nervous more
System Disturbances? Myoclonic jerk - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Myoclonic_Jerk_PM
PX300701140200 Do you observe the following Central Nervous more
System Disturbances? Myoclonic jerk (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_1_Hours_After_Feeding_AM
PX300701030100 Do you observe the following Central Nervous more
System Disturbances? Sleep < 1 Hr After Feeding (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_1_Hours_After_Feeding_Comments
PX300701030300 Do you observe the following Central Nervous more
System Disturbances? Sleep < 1 Hr After Feeding - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_1_Hours_After_Feeding_PM
PX300701030200 Do you observe the following Central Nervous more
System Disturbances? Sleep < 1 Hr After Feeding (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_2_Hours_After_Feeding_AM
PX300701040100 Do you observe the following Central Nervous more
System Disturbances? Sleep < 2 Hr After Feeding (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_2_Hours_After_Feeding_Comments
PX300701040300 Do you observe the following Central Nervous more
System Disturbances? Sleep < 2 Hr After Feeding - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_2_Hours_After_Feeding_PM
PX300701040200 Do you observe the following Central Nervous more
System Disturbances? Sleep < 2 Hr After Feeding (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_3_Hours_After_Feeding_AM
PX300701050100 Do you observe the following Central Nervous more
System Disturbances? Sleep < 3 Hr After Feeding (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_3_Hours_After_Feeding_Comments
PX300701050300 Do you observe the following Central Nervous more
System Disturbances? Sleep < 3 Hr After Feeding - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Central_Nervous_System_Disturbances_Sleep_Less_Than_3_Hours_After_Feeding_PM
PX300701050200 Do you observe the following Central Nervous more
System Disturbances? Sleep < 3 Hr After Feeding (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Excessive_Sucking_AM
PX300701260100 Do you observe the following more
Gastrointestinal Disturbances? Excessive sucking (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Excessive_Sucking_Comments
PX300701260300 Do you observe the following more
Gastrointestinal Disturbances? Excessive sucking - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Excessive_Sucking_PM
PX300701260200 Do you observe the following more
Gastrointestinal Disturbances? Excessive sucking (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Loose_Stools_AM
PX300701300100 Do you observe the following more
Gastrointestinal Disturbances? Loose stools (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Loose_Stools_Comments
PX300701300300 Do you observe the following more
Gastrointestinal Disturbances? Loose stools - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Loose_Stools_PM
PX300701300200 Do you observe the following more
Gastrointestinal Disturbances? Loose stools (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Poor_Feeding_AM
PX300701270100 Do you observe the following more
Gastrointestinal Disturbances? Poor feeding (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Poor_Feeding_Comments
PX300701270300 Do you observe the following more
Gastrointestinal Disturbances? Poor feeding - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Poor_Feeding_PM
PX300701270200 Do you observe the following more
Gastrointestinal Disturbances? Poor feeding (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Projectile_Vomiting_AM
PX300701290100 Do you observe the following more
Gastrointestinal Disturbances? Projectile vomiting (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Projectile_Vomiting_Comments
PX300701290300 Do you observe the following more
Gastrointestinal Disturbances? Projectile vomiting - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Projectile_Vomiting_PM
PX300701290200 Do you observe the following more
Gastrointestinal Disturbances? Projectile vomiting (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Regurgitation_AM
PX300701280100 Do you observe the following more
Gastrointestinal Disturbances? Regurgitation (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Regurgitation_Comments
PX300701280300 Do you observe the following more
Gastrointestinal Disturbances? Regurgitation - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Regurgitation_PM
PX300701280200 Do you observe the following more
Gastrointestinal Disturbances? Regurgitation (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Watery_Stools_AM
PX300701310100 Do you observe the following more
Gastrointestinal Disturbances? Watery stools (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Watery_Stools_Comments
PX300701310300 Do you observe the following more
Gastrointestinal Disturbances? Watery stools - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Gastrointestinal_Disturbances_Watery_Stools_PM
PX300701310200 Do you observe the following more
Gastrointestinal Disturbances? Watery stools (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Fever_Greater_Than_101_Fahrenheit_AM
PX300701180100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Fever > 101 (38.4C) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Fever_Greater_Than_101_Fahrenheit_Comments
PX300701180300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Fever > 101 (38.4C) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Fever_Greater_Than_101_Fahrenheit_PM
PX300701180200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Fever > 101 (38.4C) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Fever_Less_Than_101_Fahrenheit_AM
PX300701170100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Fever < 101 (37.2-38.3C) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Fever_Less_Than_101_Fahrenheit_Comments
PX300701170300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Fever < 101 (37.2-38.3C) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Fever_Less_Than_101_Fahrenheit_PM
PX300701170200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Fever < 101 (37.2-38.3C) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Frequent_Yawning_Greater_Than_3_AM
PX300701190100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Frequent yawning (> 3) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Frequent_Yawning_Greater_Than_3_Comments
PX300701190300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Frequent yawning (> 3) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Frequent_Yawning_Greater_Than_3_PM
PX300701190200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Frequent yawning (> 3) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Mottling_AM
PX300701200100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Mottling (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Mottling_Comments
PX300701200300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Mottling - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Mottling_PM
PX300701200200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Mottling (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Nasal_Flaring_AM
PX300701230100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Nasal flaring (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Nasal_Flaring_Comments
PX300701230300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Nasal flaring - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Nasal_Flaring_PM
PX300701230200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Nasal flaring (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Nasal_Stuffiness_AM
PX300701210100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Nasal stuffiness (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Nasal_Stuffiness_Comments
PX300701210300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Nasal stuffiness - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Nasal_Stuffiness_PM
PX300701210200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Nasal stuffiness (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Respiratory_Rate_Greater_Than_60_Min_AM
PX300701240100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Respiratory rate (> 60/min) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Respiratory_Rate_Greater_Than_60_Min_Comments
PX300701240300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Respiratory rate (> 60/min) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Respiratory_Rate_Greater_Than_60_Min_PM
PX300701240200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Respiratory rate (> 60/min) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Respiratory_Rate_Greater_Than_60_Min_With_Retractions_AM
PX300701250100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Respiratory rate (> 60/min with retractions) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Respiratory_Rate_Greater_Than_60_Min_With_Retractions_Comments
PX300701250300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Respiratory rate (> 60/min with retractions) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Respiratory_Rate_Greater_Than_60_Min_With_Retractions_PM
PX300701250200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Respiratory rate (> 60/min with retractions) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Sneezing_Greater_Than_3_AM
PX300701220100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Sneezing (> 3) (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Sneezing_Greater_Than_3_Comments
PX300701220300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Sneezing (> 3) - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Sneezing_Greater_Than_3_PM
PX300701220200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Sneezing (> 3) (PM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Sweating_AM
PX300701160100 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Sweating (AM) show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Sweating_Comments
PX300701160300 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Sweating - Comments: show less
N/A
PX300701_Neonatal_Abstinence_Syndrome_Opioid_Withdrawal_Metabolic_Vasomotor_Respiratory_Disturbance_Sweating_PM
PX300701160200 Do you observe the following Metabolic, more
Vasomotor And Respiratory Disturbance? Sweating (PM) show less
N/A
Pediatric Development
Measure Name

Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS)

Release Date

December 11, 2019

Definition

The Finnegan Neonatal Abstinence Score Tool (FNAST) 2019 Final measures 21 symptoms that are frequently observed in newborn infants following in utero exposure to maternal medications and drugs of abuse.

Purpose

Observational assessment to check for signs of withdrawal in newborns.

Keywords

Finnegan Neonatal Abstinence Score Tool, FNAST, pediatric development, opiate exposure, dependence, withdrawal