Finnegan Neonatal Abstinence Scoring System

When it activates

Scribeable activates a calculator from the encounter. The Finnegan Neonatal Abstinence Scoring System can activate when the transcript or pasted chart context documents any of these:

• Neonatal abstinence syndrome assessment
• Neonatal withdrawal scoring
• NAS evaluation
• In-utero opioid exposure monitoring
• Neonatal drug withdrawal management

Inputs the note needs

1 input. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.

Scoring

21 items across CNS (high-pitched cry, sleep disturbance, tremors, increased muscle tone, myoclonic jerks, seizures), metabolic/vasomotor (sweating, temperature, frequent yawning, mottling, nasal stuffiness, sneezing, nasal flaring, respiratory rate), and GI (excessive sucking, poor feeding, regurgitation/vomiting, loose/watery stools). Each item scored 1-5 based on severity. Total score 0-44+.

Interpretation

Score <8: Supportive care sufficient — swaddling, low stimulation, frequent small feeds, skin-to-skin contact. Score >=8 on 3 consecutive assessments (or >=12 on 2 consecutive): Pharmacotherapy initiated — first-line morphine or methadone per protocol. Scoring frequency: every 3-4 hours, more frequently if escalating. Weaning: gradual dose reduction when scores consistently <8 for 48 hours. Total treatment duration averages 17-25 days. Eat-Sleep-Console approach increasingly used as alternative to Finnegan scoring.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Finnegan 1975.

• Finnegan LP et al. Neonatal abstinence syndrome: assessment and pharmacotherapy (Finnegan Neonatal Abstinence Scoring Tool)Finnegan et al. (NAS Score) 1975 · 1975 · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Finnegan Neonatal Abstinence Scoring System at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.

The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a Finnegan Neonatal Abstinence Scoring System value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Pediatrics, Neonatology.