APGAR Assessment
APGAR stands for:
Appearance (skin color)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration (effort)
*APGAR scoring is performed at 1 minute and 5 minutes after birth and may be
reassessed at 10 minutes (5 minutes later) after birth, if the score is 6 or less.
Each category is scored 0-2 and added up for a score 0-10. The higher the score the
better the baby is doing. It is rare to have a perfect 10 because most babies have
acrocyanosis after birth where the feet and hands will be blue.
Appearance:

0: pallor or blue all over

1: body pink but extremities blue (hands and feet)…acrocyanosis

2: Body and extremities all pink

0: absent

1: <100 bpm

2: >100 bpm
Pulse:
Grimace:

0: not response to stimulation

1: grimace to stimulation (no cry)

2: cry and active movement to stimulation
Activity:

0: none, flaccid

1: some flexion of arms and legs,

2: arms and leg flexed
Respiratory:

0: absent

1: weak cry, irregular

2: strong cry
Interventions based on the APGAR Score:
Score 7-10: no interventions, baby doing good just needs routine post-delivery care
Score 4-6: some resuscitation assistance required. Oxygen, suction…. stimulate the
baby, rub baby’s back
Score 0-3: need full resuscitation
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