Apgar_score_flashcards

Question 1

What is the Apgar score used for?

Answer 1

The Apgar score is used to assess the health of a newborn baby.

Question 2

When is the Apgar score assessed?

Answer 2

NICE recommend that it is assessed at 1, and 5 minutes of age. If the score is low then it is again repeated at 10 minutes.

Question 3

What does a score of 2 for Pulse indicate?

Answer 3

> 100

Question 4

What does a score of 1 for Pulse indicate?

Answer 4

< 100

Question 5

What does a score of 0 for Pulse indicate?

Answer 5

Absent

Question 6

What does a score of 2 for Respiratory effort indicate?

Answer 6

Strong, crying

Question 7

What does a score of 1 for Respiratory effort indicate?

Answer 7

Weak, irregular

Question 8

What does a score of 0 for Respiratory effort indicate?

Answer 8

Nil

Question 9

What does a score of 2 for Colour indicate?

Answer 9

Pink

Question 10

What does a score of 1 for Colour indicate?

Answer 10

Body pink, extremities blue

Question 11

What does a score of 0 for Colour indicate?

Answer 11

Blue all over

Question 12

What does a score of 2 for Muscle tone indicate?

Answer 12

Active movement

Question 13

What does a score of 1 for Muscle tone indicate?

Answer 13

Limb flexion

Question 14

What does a score of 0 for Muscle tone indicate?

Answer 14

Flaccid

Question 15

What does a score of 2 for Reflex irritability indicate?

Answer 15

Cries on stimulation/sneezes, coughs

Question 16

What does a score of 1 for Reflex irritability indicate?

Answer 16

Grimace

Question 17

What does a score of 0 for Reflex irritability indicate?

Answer 17

Nil

Question 18

What does a total Apgar score of 0-3 indicate?

Answer 18

A very low score

Question 19

What does a total Apgar score of 4-6 indicate?

Answer 19

A moderate low score

Question 20

What does a total Apgar score of 7-10 indicate?

Answer 20

The baby is in a good state

Question 21

Apgar score summary

Answer 21

Apgar score

The Apgar score is used to assess the health of a newborn baby. NICE recommend that it is assessed at 1, and 5 minutes of age. If the score is low then it is again repeated at 10 minutes.

Score Pulse Respiratory effort Colour Muscle tone Reflex irritability
2 > 100 Strong, crying Pink Active movement Cries on stimulation/sneezes, coughs
1 < 100 Weak, irregular Body pink, extremities blue Limb flexion Grimace
0 Absent Nil Blue all over Flaccid Nil

A score of 0-3 is very low score, between 4-6 is moderate low and between 7 - 10 means the baby is in a good state

Question 22

A baby is born via a category one caesarian section. The doctors are concerned that there is very little respiratory effort and begin to assess the child.

When should the APGAR score be assessed?

1 and 10 minutes of age
1 and 15 minutes of age
1 and 5 minutes of age
10 and 30 minutes of age
2 and 10 minutes of age

Answer 22

1 and 5 minutes of age

NICE recommend that APGAR scores are routinely assessed at 1 and 5 minutes of age
Important for meLess important
The APGAR score is used to assess the health of a newborn baby. APGAR scores should be assessed at 1 and 5 minutes of age.

The APGAR score includes an assessment of the pulse, respiratory effort, colour, muscle tone and reflex irritability.

A higher score indicates that the baby is in good health. A score of 0-3 is very low, 4-6 is moderately low and 7-10 suggests the baby is in a good state. If the score is <5 at 5 minutes, APGAR scores should be repeated at 10, 15 and 30 minutes and umbilical cord blood gas sampling should be considered.

5 minutes of age is correct.

None of the other answers is consistent with when APGAR scores should be assessed

Question 23

You are asked to attend an elective Caesarean section for macrosomia and maternal diabetes. At what times should you assess the APGAR scores?

1, 2 minutes
2, 5 minutes
0, 5 minutes
1, 5 minutes
2, 4 minutes

Answer 23

NICE recommend that APGAR scores are routinely assessed at 1 and 5 minutes of age
Important for meLess important
APGAR scores should improve as they are measured at 1 and 5 minutes.

If the score remains low, it should be remeasured.

APGAR is an mnemonic for the assessment of:
Appearance (colour)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiratory effort

Question 24

A baby is born at term via vaginal delivery with no complications, however he is still not showing signs of breathing at one minute. Heart rate is >100bpm, but he is floppy and cyanosed. What is the most appropriate next step in management?

Call for anaesthetist to intubate the baby
5 mouth-to-mouth rescue breaths
5 breaths of air via face mask
Start chest compressions
Suction airways

Answer 24

5 breaths of air via face mask

Airway suction should not be performed unless there is obviously thick meconium causing obstruction, as it can cause reflex bradycardia in babies. Chest compressions are not indicated, as the HR in this case is >100bpm. CPR should only be commenced at a HR < 60bpm. In cases where there are no signs of breathing and this is thought to be due to fluid in the lungs, five breaths should be given via a 250ml bag via face mask. This is a more effective and more hygienic method than using mouth-to-mouth in a hospital setting.