The neonate is assessed using this score at intervals of 1 and 5 minutes after birth. The APGAR score may not be completed if the neonate requires resuscitation.
Assess skin coloration.0 = Blue or pale1 = Body pink, extremities blue2 = Completely pink
Assess heart rate.0 = Absent1 = Slow (<100 bpm)2 = Normal (>100 bpm)Remember that a neonate's normal heart rate lies between 120-160 bpm.
Asses reflex irritability and crying.0 = No response1 = Grimace2 = Grimace with Cough, Sneeze, or Cry
Assess flexion of the extremities.0 = Flaccid1 = Some flexion2 = Good flexion
Assess breathing rate and effort.0 = Absent1 = Slow or Irregular2 = Regular respiration or Crying
The total of each of the 5 areas are added together for the final APGAR Score. These scores indicate 0-3 = Severe Distress, 4-6 = Moderate Distress, 7-10 = Minimal to no Distress
Neonates in moderate distress at 1 minute often improve with gentle stimulation. This stimulation includes tactile methods, such as touching or rubbing the neonates back.
A neonate who is initially cyanotic may have an indication for oxygen therapy. Oxygen therapy should be initiated using the blow by method and should not be continued long term per the physician's orders.
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