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Nursing Knowledge
The APGAR score is a quick assessment of a newborn’s health that is performed at 1 and 5 minutes after birth. Healthcare providers can use the APGAR score to quickly assess a newborn’s health and determine if immediate medical care is needed. The score can also give a good indication of how well the infant is transitioning to life after delivery.
“APGAR” was developed by Dr. Virginia Apgar, and also stands for the 5 areas it evaluates:
Each area is scored from 0 to 2, and the scores are added up to give a total score between 0 and 10.
APGAR scoring table
| Indicator | 0 points | 1 point | 2 points |
| Appearance | Blue, pale | Pink body, blue extremities | Pink (pink undertones appropriate for skin color) |
| Pulse | Absent | Below 100 beats/minute | Over 100 beats/minute |
| Grimace | Floppy | Minimal response | Prompt response |
| Activity | Absent | Flexed arms and legs | Active |
| Respiration | Absent | Slow and irregular | Vigorous cry |
The scores on the APGAR test can indicate how well a newborn is transitioning to life after delivery, and if the infant needs immediate medical care.
APGAR interpretation table
| 0–3 | 4–6 | 7–10 | |
| Interpretation | Immediate medical intervention is required. | Abnormal score; specific interventions required depending on areas that scored low | Reassuring score implying newborn is transitioning well to life after delivery |
| Interventions | Initiate neonatal resuscitation protocol. | Respiratory/circulatory issues are most common, so interventions can be e.g. suctioning, fluids, ventilation. |
Specific interventions for a newborn with a low APGAR score depend on the areas that scored low. Respiratory and circulatory issues are the most common reasons for low scores, so interventions may include ventilation, suctioning, or fluids. Other interventions may be required depending on the specific needs of the newborn.
A low fifth-minute APGAR score is associated with increased risk of neonatal mortality and morbidity.
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