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. You have completed this learning
activity: Apgar scoring in the newborn