Apgar scoring
Description
Quantification of neonate’s status is based on observations of neonate’s appearance and behavior.
The scoring evaluates neonatal heart rate, respiratory effort, muscle tone, reflex irritability, and color.
Equipment
Stethoscope
Gloves
Essential steps
Perform evaluation of each category 1 minute and 5 minutes after birth.
Score each category as 0, 1, or 2.
Obtain the final Apgar score by adding the scores for each category; the maximum score is 10.
Heart rate
Assess heart rate first.
If the umbilical cord still pulsates, palpate the neonate’s heart rate by placing your fingertips at the junction of the umbilical cord and the skin.
AlertThe neonate’s cord stump continues to pulsate for several hours and is a good, easy place (next to the abdomen) to check heart rate. When palpating at the cord stump, be sure to wear gloves.
Alternatively, place two fingers or a stethoscope over the neonate’s chest at the fifth intercostal space to obtain an apical pulse.
Count the heart rate for 1 full minute.
Respiratory effort
Assess the neonate’s cry, noting its volume and vigor.
Auscultate his lungs, using a stethoscope.
Assess his respirations for depth and regularity.
Alert
