APGAR SCORE PARAMETERS

Assess the newborn by assigning an Apgar score at 1 and 5 minutes.

The Apgar score assesses five parameters
-(1) heart rate (absent, slow, or fast)
- (2)respiratory effort (absent, weak cry, or good strong yell)
- (3) muscle tone (limp, or lively and active)
- (4) response to irritation stimulus
- (5) color—that evaluate a newborn’s cardiorespiratory adaptation after
birth.

The parameters are arranged from the most important (heart rate) to the

least important (color).
The newborn is assigned a score of 0 to 2 in each of the five parameters.
The purpose of the Apgar assessment is to evaluate the physiologic status of
the newborn.

Measurements
These measurements are taken soon after birth.
 A disposable tape measure or a built-in measurement board located on the side of
some scales can be used.

 Length is measured from the head of the newborn to the heel with the newborn
unclothed.

 Because of the flexed position of the newborn after birth, place the newborn in a supine
position and extend the leg completely when measuring the length.

 The expected length range of a full-term newborn is usually 44 to 55 cm (17 to 22 in).

Newborns can be classified by their birth weight regardless of their gestational age as follows:
- Low birth weight: >2,500 g (>5.5 lb)
- Very low birth weight: >1,500 g (>3.5 lb)
- Extremely low birth weight: >1,000 g (>2.5 lb)

* APGAR SCORING RESULTS *

!!! Performed at: 1 minute and 5 minutes after birth and 10 minutes if score 6 or less!!!

* The newborn is assigned a score of 0 – 2 in each of the 5 parameters, where a score of 0

points indicates an absent or poor response; a score of 2 points indicates a normal response =
the higher the score the better the baby is doing.
* If the Apgar score is 8 points or higher, no intervention is needed other than supporting
normal respiratory efforts and maintaining thermoregulation.
* Scores of 4 to 7 points signify moderate difficulty.
* Scores of 0 to 3 points represent severe distress in adjusting to extrauterine life.
!!!Its not usual to have a perfect 10 because most babies have acrocyanosis!!!

- Interventions Based on Score –

7 – 10: routine post-delivery care.
4 – 6: some resuscitation; ex: Oxygen, suction, stimulate baby.
0 – 3: Full resuscitation.

- RESUSCITATION –
* If a newborn needs resuscitation, immediately at delivery, initiate it before one minute Apgar
Scoring.
* Be certain to check all resuscitative equipment prior to the delivery to make sure it is
functioning properly.
*Document your findings and interventions in the newborn’s medical record.