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

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.

Availability

Available

Download PDF

Protocol

Finnegan Neonatal Abstinence Scoring Toll (FNAST)

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

Signs and Symptoms

Score

Comments

Central Nervous System Disturbances

Crying: Excessive High Pitched

Crying: Cont. High Pitched

Sleep < 1 Hr After Feeding

Sleep < 2 Hr After Feeding

Sleep < 3 Hr After Feeding

Hyperactive Moro reflex

Markedly Hyperactive Moro reflex

Mild Tremors: Disturbed

Mod-Severe Tremors: Disturbed

Mild Tremors: Undisturbed

Mod-Severe Tremors: Undisturbed

Increased muscle tone

Excoriation (Specific Area)

Myoclonic jerk

Generalized convulsions

Metabolic, Vasomotor And Respiratory Disturbance

Sweating

Fever < 101 (37.2-38.3C)

Fever > 101 (38.4C)

Frequent yawning (> 3)

Mottling

Nasal stuffiness

Sneezing (> 3)

Nasal flaring

Respiratory rate (> 60/min)

Respiratory rate (> 60/min with retractions)

Gastrointestinal Disturbances

Excessive sucking

Poor feeding

Regurgitation

Projectile vomiting

Loose stools

Watery stools

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.

Personnel and Training Required

Clinically trained staff

Equipment Needs

Thermometer and stopwatch/clock with a second hand

Requirements

Requirement Category	Required
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

Lifestage

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

Standard	Name	ID	Source

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 ID	Variable Description	dbGaP 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	N/A
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	N/A
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

Measure Protocols

Protocol ID	Protocol Name
300701	Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS)

Publications

There are no publications listed for this protocol.