APGAR Score (Appearance, Pulse, Grimace, Activity, Resps)

Last updated 20.09.12

 

Index

 

Definition

-  Assessment of neonatal state of consciousness & responsiveness in the minutes immediately post delivery

 

Features

-  Assess health of newborn immediately after birth

-  Observer dependant

-  Should describe neonate as well as use score

-  Used as indicator for requirements of immediate medical care: neonatal resusitation

-  Not designed as long term predictor

 

Procedure

-  Score for each of 5 criteria given from 0 – 2

-  Total scores range from 0 – 10

-  Appearance: skin color

-  Blue = 0

-  Blue limb, pink centrally = 1

-  Pink = 2

-  Pulse: HR

-  Absent = 0

-  < 100 = 1

-  > 100 = 2

-  Grimace: reflex irritability

-  Nil = 0

-  Grimace, cry = 1

-  Sneeze, cough, pulls away = 2

-  Activity: muscle tone

-  None = 0

-  Flexion = 1

-  Active = 2

-  Respiration: breathing

-  Absent = 0

-  Weak, irregular = 1

-  Strong = 2

 

Timing

-  1st score at 1 minute, 2nd at 5 minutes

-  Subsequent scores at 5 min intervals if required

 

Results

-  Score at 1 min indicates need for stimulation

-  Score at 5 min indicates response to prev resuscitation

-  Normal 7 – 10

-  Low 4 – 6

-  Critically low < 4

-  Scores < 3 after 10 minutes may indicate long term neurological impairment, possibly cerebral palsy

 

 

 

References