Apgar Score

APGAR SCORE

Virginia Apgar (1909-1974)

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The Apgar score is a practical method for assessing a neonate. Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar.

How is the Apgar score done? The Apgar score is a number calculated by scoring the heart rate, respiratory effort, muscle tone, skin colour, and reflex irritability (response to a catheter in the nostril). Each of these objective signs can receive 0, 1, or 2 points.

What does a high or low Apgar score mean? A perfect Apgar Score of 10 means an infant is in the best possible condition. An infant with an Apgar Score of 0-3 needs immediate resuscitation. It is important to note that diligent care of the newborn is an immediate response to the current status of the infant. It is inappropriate to wait until Apgar Scores are obtained to begin or continue to address the needs of the neonate.

When is the Apgar scoring done? The Apgar score is done routinely 60 seconds after the birth of the infant and then is repeated five minutes after birth. In the event of a difficult resuscitation, the Apgar score may be done again at 10, 15, and 20 minutes.

During Apgar Score

Apgar sign/ Apgar scoring Activity (muscle tone) Pulse (heart rate)

2

1

Active, spontaneous movement

Arms and legs flexed with little movement

No movement, “floppy” tone

Normal (above 100 beats per minute)

Below 100 beats per minute

Absent (no pulse)

Grimace Pulls away, (reflex irritability) sneezes, or coughs with stimulation

Facial movement Absent (no only with response to stimulation stimulation)

Appearance Normal colour all Normal colour (skin colouration) over (hands and (but hands and feet are pink) feet are bluish) Respiration (breathing rate)

0

Normal rate and effort, good cry

Slow or irregular breathing, weak cry

Bluish gray or pale all over Absent (no breathing)

A baby who scores a 7 or above on the test at 1 minute after birth is generally considered in good health. However, a lower score doesn't necessarily mean that your baby is unhealthy or abnormal. It may mean that your baby simply needs some special immediate care, such as suctioning of the airways or oxygen to help him or her breathe, after which your baby may improve.

Video of a boy doing the Apgar Score