II. Background

  1. Used only for documentation, not for Resuscitation
  2. See Newborn Resuscitation
  3. Calculate score at 1 and 5 minutes
  4. Calculate score at additional 5 minute intervals
    1. Until APGAR Score exceeds 6

III. Calculation (Maximum of 10 points)

  1. Appearance
    1. Blue: 0
    2. Acrocyanotic: 1
    3. Pink: 2
  2. Pulse
    1. Absent Pulse: 0
    2. Heart Rate under 100 beats per minute: 1
    3. Heart Rate over 100 beats per minute: 2
  3. Grimace (Reflex irritability)
    1. No response: 0
    2. Grimace: 1
    3. Vigorous cough or sneeze: 2
  4. Muscle tone
    1. Limp: 0
    2. Some flexion of extremities: 1
    3. Active motion: 2
  5. Respiratory effort
    1. Respirations Absent: 0
    2. Slow or irregular breaths: 1
    3. Good Respiratory Rate and cry: 2

IV. Interpretation

  1. One minute Apgar (term infants)
    1. Apgar <5: Lower pH and higher PaCO2
    2. Apgar >7: Suggests stable oxygenation and perfusion
  2. Five minute Apgar
    1. Reflects infants changing condition

V. Reference

  1. Apgar (1953) Anesth Analg 32:260

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