Ep0032: APGAR Scoring

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The APGAR score is a simple way to objectively determine how well a baby is doing immediately after birth.

It is measured at 1 minute and 5 minute intervals. It helps to determine whether the baby needs resuscitation and might need the NICU.  We look at their Appearance – looking for pink torso and extremities, a Pulse above 100, their Grimace or response to stimuli (we want them crying!), how Active they are and their Respiratory effort.

Each of these things are scored on a scale of 0-2. A score of 8-10 is normal, 4-6 indicates depression in normal vital functions – these babies will likely need some help after birth, and a score of 0-3 requires aggressive resuscitation and likely a transfer to the NICU.  

Let’s look at an example. Let’s say a baby’s 1-minute APGAR was 9 because they weren’t crying vigorously. At 5 minutes, we check again and the baby is pink all over (that’s a 2), but her heart rate is in the 90s (that’s a 1), she’s still not crying vigorously, but she is responding to stimuli (that’s a 1), she isn’t very active, her movement is limited (that’s also a 1), and her breathing has become irregular (that’s also a 1).

So the total score is a 6. We see the baby’s APGAR has dropped from a 9 to a 6, so we know something isn’t right. This baby is going to need more detailed attention and possible resuscitation.

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