Apgar

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APGAR SCORES

Professor Virginia Apgar (1909-1974)

• American paediatric anaesthesiologist

• Founder of neonatology field

• Also founder of Apgar score (1952)

← “designed first standardized method for evaluating newborns transition to life outside the womb”

← Further related Apgar score to labour, delivery and anaesthetics

← Apgar score at 5 min can predict neonatal survival and neurological development

• In 1949: she was the 1st woman at Columbia University college of Physicians and Surgeons to be named FULL PROFESSOR

The Primary Purpose of the Apgar score

• Part of early assessment of newborn’s clinical condition at 1min and 5min after birth normally,

but every 5min until newborn is stable

• 5 physical signs on a scale of 0-2 (Appearance, Pulse, Grimace, Activity and Respiratory)

• Maximum is 10/10

Minimum is 0/10

• Score of 7-10 is normal

100bpm

← 1: < 100bpm

← 0: absent heart rate

3. Grimace: determining response to stimulus

• Dry newborn with a towel

• Flicking of feet once is all that is necessary

← 2: responds appropriately (crying, movement)

← 1: slight grimace, response is poor

← 0: no response

4. Activity: assessing muscle tone

• Lie newborn face up (supine position)

• Arms and legs move more actively in the air or in the flexed position (against body)

← 2: normal movement, good flexion

← 1: some movement, some flexion

← 0: absent movement, flaccid

5. Respiratory: assessing respiratory effort

← 2: good crying and respiratory movements

← 1: poor; irregular breathing, occasional gasping

← 0: no attempt to breathe

• Ventilation: stop and check for spontaneous respiration (few seconds)

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Resources:

1. www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography-12.html

2....
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