Apgar score - wikipedia Apgar score Virginia Apgar. Apgar score is a method to quickly summarize the health of newborn children. Dr. Virginia Apgar, an anesthesiologist at NewYork -- Presbyterian Hospital, developed the score in 1952 in order to quantify the effects of obstetric anesthesia on babies. The Apgar scale 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 are summarized using words chosen to form a backronym ( Appearance, Pulse, Grimace, Activity, Respiration ). Contents 1 Criteria 2 Interpretation of scores 3 Backronym 4 See also 5 References 6 Further reading Criteria The five criteria of the Apgar score : Score of 0 Score of 1 Score of 2 Component of backronym Skin color blue or pale all over blue at extremities body pink ( acrocyanosis ) no cyanosis body and extremities pink Appearance Pulse rate absent < 100 beats per minute > 100 beats per minute Pulse Reflex irritability grimace no response to stimulation grimace on suction or aggressive stimulation cry on stimulation Grimace Activity none some flexion flexed arms and legs that resist extension Activity Respiratory effort absent weak, irregular, gasping strong, robust cry Respiration Interpretation of Scores Mind map showing summary for the Apgar score 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 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low. A low score on the one - minute test may show that the neonate requires medical attention but does not necessarily indicate a long - term problem, particularly if the score improves at the five - minute test. An Apgar score that remains below 3 at later times -- such as 10, 15, or 30 minutes -- may indicate longer - term neurological damage, including a small but significant increase in the risk of cerebral palsy. However, the Apgar test 's purpose is to determine quickly whether a newborn needs immediate medical care. It is not designed to predict long term health issues. A score of 10 is uncommon, due to the prevalence of transient cyanosis, and does not substantially differ from a score of 9. Transient cyanosis is common, particularly in babies born at high altitude. A study that compared babies born in Peru near sea level with babies born at very high altitude ( 4340 m ) found a significant average difference in first Apgar score, but not the second. Oxygen saturation ( see Pulse oximetry ) also was lower at high altitude. Backronym Some ten years after initial publication, a backronym for APGAR was coined in the United States as a mnemonic learning aid : Appearance ( skin color ), Pulse ( heart rate ), Grimace ( reflex irritability ), Activity ( muscle tone ), and Respiration. Spanish : Apariencia, Pulso, Gesticulación, Actividad, Respiración ; Portuguese : Aparência, Pulso, Gesticulação, Atividade, Respiração ; French : Apparence, Pouls, Grimace, Activité, Respiration ; German : Atmung, Puls, Grundtonus, Aussehen, Reflexe, representing the same tests but in a different order ( respiration, pulse, muscle tone, appearance, reflex ). Another eponymous backronym from Virginia Apgar 's name is American Pediatric Gross Assessment Record. Another mnemonic for the test is `` How Ready Is This Child ? '' -- which summarizes the test criteria as Heart rate, Respiratory effort, Irritability, Tone, and Color. See also Ballard Maturational Assessment Bishop score Glasgow Coma Scale Paediatric Glasgow Coma Scale References ^ Jump up to : Apgar, Virginia ( 1953 ). `` A proposal for a new method of evaluation of the newborn infant ''. Curr. Res. Anesth. Analg. 32 ( 4 ) : 260 -- 267. doi : 10.1213 / 00000539 - 195301000 - 00041. PMID 13083014. Jump up ^ Finster, M. ; Wood, M. ( May 2005 ). `` The Apgar score has survived the test of time ''. Anesthesiology. 102 ( 4 ) : 855 -- 857. doi : 10.1097 / 00000542 - 200504000 - 00022. PMID 15791116. Jump up ^ Holton, Tim. `` What Are APGAR Scores, And Why Are They Important ? ''. www.holtonlaw.com. Jump up ^ Casey, B.M. ; McIntire, D.D. ; Leveno, K.J. ( February 15, 2001 ). `` The continuing value of the Apgar score for the assessment of newborn infants ''. N Engl J Med. 344 ( 7 ) : 467 -- 471. doi : 10.1056 / NEJM200102153440701. PMID 11172187. Jump up ^ Gonzales, G.F. ; Salirrosas, A. ( 2005 ). `` Arterial oxygen saturation in healthy newborns delivered at term in Cerro de Pasco 14,138 feet ( 4340 m ) and Lima 492 ft ( 150 m ) ''. Reproductive Biology and Endocrinology : RB&E. 3 : 46. doi : 10.1186 / 1477 - 7827 - 3 - 46. PMC 1215518. PMID 16156890. Further reading Apgar, Virginia ( 1966 ). `` The Newborn ( Apgar ) Scoring System : Reflections and Advice '' ( PDF ). Pediatric clinics of North America. 13 : 645 -- 650. ( Retrieved from Profiles in Medicine - The Virginia Apgar Papers ) Medical examination and history taking Medical history Chief complaint History of the present illness Systems review Nursing assessment Allergies Medications Past medical history Surgical history Family history Social history Psychiatric history Progress notes Mnemonics SAMPLE OPQRST SOAP COASTMAP Physical examination General / IPPA Inspection Auscultation Palpation Percussion Vital signs Temperature Heart rate Blood pressure Respiratory rate HEENT Oral mucosa TM Eyes ( Ophthalmoscopy, Swinging - flashlight test ) Hearing ( Weber, Rinne ) Respiratory Respiratory sounds Cyanosis Clubbing Cardiovascular Precordial examination Peripheral vascular examination Heart sounds Other Jugular venous pressure Abdominojugular test Carotid bruit Ankle - brachial pressure index Abdominal Digestive Liver span Rectal Murphy 's sign Bowel sounds Urinary Murphy 's punch sign Extremities / Joint Back ( Straight leg raise ) Knee ( McMurray test ) Hip Wrist ( Tinel sign, Phalen maneuver ) Shoulder ( Adson 's sign ) GALS screen Neurological Mental state Mini -- mental state examination Cranial nerve examination Upper limb neurological examination Neonatal Apgar score Ballard Maturational Assessment Gynecological Well - woman examination Vaginal examination Breast examination Cervical motion tenderness Assessment and plan Medical diagnosis Differential diagnosis Medical mnemonics ( list ) ABC AEIOU - TIPS APGAR ASHICE CASMEET DCAP - BTLS FAST Hs and Ts IS PATH WARM ? MARCHE OPQRST RICE RNCHAMPS RPM - 30 - 2 - Can Do SAD PERSONS SAMPLE SBAR SOAP SOCRATES Retrieved from `` https://en.wikipedia.org/w/index.php?title=Apgar_score&oldid=811966483 '' Categories : American inventions Pediatrics Medical scales Medical assessment and evaluation instruments Hidden categories : All articles with unsourced statements Articles with unsourced statements from May 2017 Talk Contents About Wikipedia Azərbaycanca Bosanski Català Чӑвашла Čeština Deutsch Español فارسی Français Galego 한국어 Hrvatski Bahasa Indonesia Italiano עברית Македонски Nederlands 日本 語 Norsk Norsk nynorsk Polski Português Русский Simple English Српски / srpski Srpskohrvatski / српскохрватски Suomi Svenska தமிழ் ไทย Türkçe Українська Tiếng Việt 中文 Edit links This page was last edited on 25 November 2017, at 02 : 54. Text is available under the Creative Commons Attribution - ShareAlike License ; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. 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Question: a baby is considered to be in critical condition if her score on the apgar scale is below
Answer: 4 to 6 fairly low, and 3 and below are generally regarded as critically low