1. Zhallene Michelle E. Sanchez
APGAR SCORING
Prepared by:
Zhallene Michelle E. Sanchez

2. APGAR SCORE
The APGAR Scoring System was developed by Dr. Virginia Apgar as a method of assessing the newborn’s adjustment to extrauterine life.
is a practical method of systematically assessing newborns immediately after birth to help identify infants requiring resuscitation.

3. APGAR SCORE It is taken at one minute and five minutes after birth.
With depressed infants, repeat the scoring every five minutes as needed.
The one minute score indicates the necessity for resuscitation.
The five minute score is more reliable in predicting mortality and neurologic deficits.

4. APGAR SCORE
The most important is the heart rate, then the respiratory rate, the muscle tone, reflex irritability and color follows in decreasing order.

5. HEART RATE
Auscultating the newborn heart with a stethoscope is the best way of determining heart rate; however heart rate also maybe obtained by observing and counting the pulsations of the cord at the abdomen if the cord is still uncut.

6. Respiratory Effort
A mature newborn usually cries sponstaneously at about 30 seconds after birth. By 1 minute he or she is maintaining regular, although rapid, respirations.
Difficulty might be anticipated in a newborn whose mother received large amounts of analgesia or a general anesthetic during labor or birth.

7. Reflex Irritability
One of two possible cues is used to evaluate reflex irritability: either the newborn’s response to a suction catheter in the nostril or the response to having the soles of the feet slapped. A baby whose mother heavily sedated will probably demonstrate a low score in this category.

8. Muscle Tone
Mature newborns hold the extremities tightly flexed, simulating their intrauterine position. They should resist any effort to extend their extremities.

9. Color
All infants appear cyanotic at the moment of birth. They grow pink with or shortly after the first breath. The color of newborns thus corresponds to how well they are breathing.

10. Color
Acrocyanosis ( cyanosis of the hands and feet) is so common in newborns that a score of 1 in this category can be thought of as normal. This means that the central portion (chest) is pink, but the extremities, particularly the hands and feet, are blue or purple.

11. Color
Asses the pinkness of the fetal skin. Totally pink scores 2.

12. Color
Cyanosis is not normal and indicates the need for treatment. It is due to the accumulation of desaturated (oxygen-depleted) hemoglobin.

13. Color
Cyanosis due to airway obstruction is treated by opening the airway. Cyanosis due to inadequate ventilations is treated by ventilating the baby. In mild cases, cyanosis may be resolved by providing 100% oxygen to the baby.

14. APGAR SCORE CHART CRITERIA INDICATOR 1 2 Pulse Heart Rate absent1 2
Pulse
Heart Rate
absent
Less than 100
More than 100
Respirations
Respiratory Effort
Slow, irregular; weak cry
Good; strong cry
Activity
Muscle Tone
Flaccid, limp
Some flexion of extremities
Well flexed
Grimace
-response to catheter in nostril
-slap to sole of foot
Reflex irritability
No response
-Grimace
-Cough or sneeze
-Cry and withdrawal of foot
Appearance
Color
Blue, pale
Body normal pigment, extremities blue
Normal skin coloring; Pink

15. SCORE 7-10 at 1 minute = vigorous infant
4-6 = mild-moderate asphyxia % O2 by face mask
0-3 = severe asphyxia --- intubation

16. Thank you and have a nice day…