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1Apgar Newborn Scoring Chart
Mother’s Name: ________________________________________________________________
Reference Record #: ____________________________________________________________
Tel: (home) ________________________
(Mobile) ___________________________________
Newborn’s details:
□
□
Date & Time of Birth: ____________________________
Gender:
Male
Female
Sign
0
1
2
Activty (muscle tone)
Absent/limp
Arms, legs flex, show some
Arms and legs actively moving
resistance to extension
and flexing
Pulse (heart rate)
Absent
Below 100 beats per minute
Above 100 beats per
minute
Grimace (Response to catheter in nostril after
No response
Facial grimace
Cough, sneeze, cry, pull
cleared)
away/resist
Appearance (skin color)
Blue, blue-gray,
Pink body, blue extremities
Completely pink/normal
pale
coloring all over body
Respiratory effort (breathing)
Absent
Slow, irregular, shallow
Good, sustained crying,
regular breathiing
60 seconds after the baby is born, observe these five objecti ve signs and evaluate by giving and a score of 0, 1, or 2 to each.
•
Total score of 10 is the best possi ble condition; 7-10 is considered normal.
•
An infant with a score of 0-3 requires immediate resuscitation/medical attention; scores of 4-7 may require resuscitation.
Notes / Comments / Details:
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Parent category: Medical