1. Providence Nursing institute Clinical Academy OBSTETRIC CURRICULUM
APGAR Practice
Providence Nursing institute
Clinical Academy
OBSTETRIC CURRICULUM

2. Apnea: Review Before OR After Birth 2016.06
Delivery can happen at any point in this graph – therefore the baby may be born at the beginning and you may see 1st and 2nd apnea OR the baby could be born during 2nd apnea and will not improve without PPV
If delivery happens during primary apnea, stimulation will usually start resps
If it occurs during secondary apnea, respirations will not resume until resuscitation is initiated
If this process impedes resps, then it affects all 3 critical things that must occur
Expansion
Gas Exchange
Closure of the ducts
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Merenstein & Gardner, 7th ed. (p. 54)

3. APGAR Score What is it? When do we use it? What does it tell us?
How Ready Is This Child?
Score 1 2
Appearance
Blue/Pale
Body Pink
Extremities Blue
Completely Pink
Pulse
Absent
Below 100
Above 100
Grimace
No Response
Cough/Sneeze
Activity
Limp
Some flexion
Well flexed
Respirations
Weak/irregular
Strong cry
How Ready Is This Child?
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4. What Comes First? A…B…C…
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5. APGAR PRACTICE
Baby #1
Video clip is hyperlinked:
There is a slight pause in the video right at the beginning … it will start again in about 5 seconds!

6. Providence Clinical Academy7 8 9 10
Baby’s First Test
What would you give this baby for her 1 minute APGAR?
Let’s say HR >100

7. The Misbehavers
What if things don’t go well? Any experiences with this? What did you see/do?
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8. Baby #2 APGAR PRACTICE Excellent example of secondary apnea
Video clip is hyperlinked:

9. 2 4 5 8 What interventions did you see the RNs doing?
Providence Clinical Academy 2 4 5 8
Baby’s First Test
What interventions did you see the RNs doing?
What was the outcome?
What would you give this baby for his 1 minute APGAR?
Let’s say HR >100

10. THANK YOU!!
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