Apgar Score
As
soon as the baby born, there is a major transition from intrauterine existence
to independent living. The colors of the baby, muscle tone respiratory effort
the heart rate and the sound of cry give us an understanding of how born is
making these initial adjustments.
The Apgar score was devised in 1952 by Dr. Virginia Apgar as a
simple and repeatable method to quickly and summarily assess the health of
newborn children immediately after childbirth. Apgar was an anesthesiologist
who developed the score in order to ascertain the effects of obstetric
anesthesia on neonates. This
is rapid evaluation of baby the first few minutes of life. This scoring system
is called APGAR SCORING SYSTEM based on given objective signs.
The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria (Appearance, Pulse, Grimace, Activity, Respiration) are used as a mnemonic learning aid.
Sign |
Sore |
||
0 |
1 |
2 |
|
Hear Rate |
Absent |
Below 100 |
Over 100 |
Respiratory Effort |
Absent |
Slow irregular |
Good crying |
Muscle Tone |
placid |
Some flexion |
Active motion |
Reflex (Response to catheter in nostril) |
No Response |
Grimace |
Cough or sneeze |
Color |
Blue, Pale |
Body pink Extremities Blue |
Completely pink |
*Scoring 8 to 10 is normal |
|||
*Scoring below 7 high risk infant |
Apgar Scoring
1. No Asphyxia 8-10
2. Mild Asphyxia 5-7
3. Moderate Asphyxia 3-4
Severe Asphyxia 0-2
We must evaluate APGAR scoring both at one minute and five minuets after birth:
II. Five Minutes Apgar score: This score correlates best with the future neurological outcome. Most children with Apgar score of 7 at 5mts will be normal in follow up. To improve APGAR Score the methods to be followed at periphery are:
1. Gentle clearing of air way by suction bull.
2. Gentle tactile stimulation of soles as well as back should be done.
3. Cleaning and drying of head which comprises 20% surface
area to prevent hypothermia.
* Poring of cold water and Vigorous slapping of back and buttock should not be done.
From wikipedia sources.....
Criteria
Acrocyanosis The five criteria of the Apgar score:
|
Score of 0 |
Score of 1 |
Score of 2 |
Component of
Acronym |
Skin color |
blue all over |
blue at extremities |
no cyanosis |
Appearance |
Heart rate |
absent |
<100 |
>100 |
Pulse |
Reflex irritability |
no response to stimulation |
grimace/feeble cry when stimulated |
sneeze/cough/pulls away when stimulated |
Grimace |
Muscle tone |
none |
some flexion |
active movement |
Activity |
Breathing |
absent |
weak or irregular |
strong |
Respiration |
Interpretation of scores
The test is generally done at one and five minutes after birth, and may be repeated later if the score is and remains low. Scores 3 and below are generally regarded as critically low, 4 to 6 fairly low, and 7 to 10 generally normal.
A low score on the one-minute test may show that the neonate requires medical attention but is not necessarily an indication that there will be long-term problems, particularly if there is an improvement by the stage of the five-minute test. If the Apgar score remains below 3 at later times such as 10, 15, or 30 minutes, there is a risk that the child will suffer longer-term neurological damage. There is also a small but significant increase of the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long-term predictions on a child's health.
Contrary to common belief, the Apgar score is no longer used to decide if a neonate requires resuscitation. That decision is based on emergency assessment of airway, breathing, and circulation ("ABC").
Acronym
Some ten years after the initial publication, the
acronym APGAR was coined in the
Another such backformation attempting to make Apgar an acronym is American Pediatric Gross Assessment Record. The test, however, is named for Dr. Apgar, making Apgar an eponymous backronym.
The test has also been reformulated with a different mnemonic, How Ready Is This Child, but the criteria are essentially the same: Heart rate, Respiratory effort, Irritabililty, Tone, and Color.email: pad9nagsai@gmail.com
History INDEX Know the Value of Vitamins