Single Best Answer (SBA) · Examination and Care of the Newborn
At one minute of life a newborn has a heart rate of 80 beats per minute, slow irregular respirations, some flexion of the limbs, a grimace in response to stimulation, and a pink body with blue extremities (acrocyanosis). What is this baby's Apgar score?
Show answer and explanation
Answer: C. A score of 5
Calculating the Apgar score
The Apgar score assesses five signs, each scored 0, 1 or 2 (maximum 10), at 1 and 5 minutes.
| Sign | 0 | 1 | 2 | This baby |
|---|---|---|---|---|
| Colour | Pale/blue | Body pink, extremities blue | Completely pink | 1 (acrocyanosis) |
| Heart rate | Absent | <100 | >=100 | 1 (HR 80) |
| Reflex/grimace | None | Grimace | Cry/cough | 1 (grimace) |
| Tone | Limp | Some flexion | Active motion | 1 (some flexion) |
| Respiration | Absent | Slow/irregular | Good/crying | 1 (slow irregular) |
Each sign scores 1, totalling 5.
Interpretation
- A score that is low indicates a need for neonatal resuscitation; the score is recorded at 1 and 5 minutes (and repeated if low).
- Acrocyanosis (blue hands and feet with a pink body) is normal in a newborn and scores 1 for colour - a completely pink baby is needed to score 2.
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