Apgar scoring in the newborn.
Apgar scoring was developed in 1953 by dr.Vvirginia Apgar who described five
signs that could be determined easily and without interfering with the care of
the infant.
A rating of zero one or two is given to each sign depending on whether it is
absent or present. a score of 10 indicates a baby in the best possible
condition.
the judging of the five objective signs is generally done at one minute of age
after delivery and at five minutes of age.
a score of seven to ten is considered normal while four to seven might require
some resuscitative measure. a score of 3 and below requires
immediate resuscitation.
This chart indicates each of the signs and scores
Apgar scoring for newborns.
the Apgar score was published in 1953. ten years later an acronym was reported
in the Journal of the American Medical Association that helped teach the Apgar
score by using the letters a P G a and R. this acronym was co-authored by .
dr. Joseph Butterfield.
Activity, muscle tone, muscle tone refers to the amount
of active motion of the extremities. A score of zero indicates a newborn who
is limp and without movement.
a score of 1 indicates a newborn has some flexion of the extremities.
a score of 2 is an excellent score which indicates spontaneous movement of
arms and legs that resist extension.
Pulse refers to the heart rate of the newborn during the time of scoring.
the heart rate is determined by placing a stethoscope on the newborns chest and
listening for the heart rate.
a score of zero indicates that there is no heart rate.
a score of 2 indicates that there is a heart rate of 100 to 140.
reflex irritability. reflex irritability refers to a response to some form of
stimulation such as suctioning the nose and mouth. suctioning with a bulb syringe
after delivery to clear the airway often elicits a response of facial grimacing
sneezing or coughing. a score of zero indicates that there is
no response to any stimulation.
a score of 1 indicates that there is slight grimacing with no sneezing or
coughing with stimulation.
A score of two indicates that there is grimacing sneezing coughing crying or
vigorous movement with stimulation. all infants are cyanotic at birth
because of their high capacity for carrying oxygen and the low oxygen
saturation in their blood. the disappearance of cyanosis depends on
respiratory effort and heart rate.
a score of zero indicates that the infant remained gray pale or obviously
cyanotic over the trunk and extremities.
a score of 1 indicates that the infant's skin color is pink with the exception of
the hands and feet. this is called acrocyanosis acrocyanosis is very common
and can occur in spite of excellent ventilation. most infants fall into this
category.
a score of two indicates a newborn's entire body and extremities are pink.
respiratory effort: this refers to the newborns respiratory effort at sixty
seconds and five minutes of age.
a score of zero indicates that there is no respiratory effort. this is referred
to as apnea.
a score of 1 indicates that there is irregular shallow ventilation or a gasp
once at 30 or 45 seconds after birth. a score of 2 indicates that there is
regular breathing and/or a lusty cry.
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