APGAR Score

a. Incident # __________________

b. Mother’s Name: ____________________ __________________________

(Last Name) (First Name)

c. Patient’s Name: _____________________ __________________________

(Last Name) (First Name)

All newborns will be assessed on the APGAR scale at intervals of 1 and 5 minutes, unless there is a demise of the patient, then additional scores are recommended. This system evaluates the status of a newborn’s vital functions.

	0	1	2	1 Minute Score	5 Minute Score
Appearance	Body and extremities blue, pale	Body pink, extremities blue	Completely pink
Pulse Rate	Absent	Below 100/min	100/min or above
Grimace	No Response	Grimace	Cough, sneeze, cry
Activity	Limp	Some flexion of extremities	Active motion
Respiratory Effort	Absent	Slow & irregular	Strong Cry
			Total Score=

Scores of 0-3= severely depressed and require immediate ventilatory and circulatory support

Scores of 4-6= moderately depressed and require oxygen and stimulation to breath

Scores of 7-10=generally healthy newborn and require supportive measures only