Tuesday, May 4, 2010

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Apgar scoring - table, mnemonic


The Apgar score was devised in 1952 by Dr Virginia Apgar (anesthesiologist) as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after birth. 

This helps to identify those requiring resuscitation and can also be used to predict survival in the neonatal period. 

apgar chart

A mnemonic for learning purposes includes:

A - Appearance (skin colour)
P - Pulse (heart rate)
G - Grimace (reflex irritability)
A - Activity (muscle tone)
R - Respiration 

apgar mnemonic

Another mnemonic is also useful: 

How -   Heart rate
Ready - Respiration
Is -        Irritability
This -    Tone
Child -   Colour

apgar test chart
Apgar scoring is divided into 1 and 5-min scores.

Sixty seconds after complete birth, the five parameters specified in the table above must be evaluated and scored. A total score of 10 indicates that the baby is in the best possible condition. A score between 0-3 means that immediate resuscitation must be done. The score was not designed to predict neurological outcomes. It is normal in most patients who subsequently go on to develop cerebral palsy.

The score at 5 minutes associated with a low pH is a better indicator of neonatal mortality. Umbilical artery pH less than 7 and a 5-min score of 0-3 increases the relative risk of mortality in both pre-term and term babies.

First published on : 4 May 2010
Last reviewed on : 12 September 2015


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