REMAC of N.Y.C. - A.L.S. Protocols

Regional Emergency Medical Advisory Committee of New York City
Prehospital Advanced Life Support Protocols
Copyright January 1996 (3/96)

APPENDIX K

APGAR SCORING SYSTEM

The patient is scored 0 - 2 points for each clinical sign. Maximum total score is 10. The score is determined at 1 and 5 minutes of life. The higher the score, the better.

SIGN	0	1	2
Heart Rate	Absent	Below 100	Over 100
Respiration (effort)	Absent	Slow and irregular	Normal; crying
Muscle Tone	Limp	Some flexion - extremities	Active; good motion in extremities
Irritability	No Response	Crying: some motion	Crying; vigorous
Skin Color	Bluish or pale	Pink or typical newborn color; hands and feet are blue	Pink or typical newborn color; entire body

A score of:	8 - 10 is generally normal
	5 - 7 indicates a need for supplemental oxygen
	3 - 4 indicates a need for Bag-Valve-Mask ventilation
	0 - 2 generally indicates a need for CPR

NOTE:	A SCORE OF 7 OR LESS REQUIRES IMMEDIATE INTERVENTION. (SEE PROTOCOL # 443).
	THE MANAGEMENT OF RESPIRATORY DISTRESS OR CARDIOVASCULAR INSTABILITY TAKES PRIORITY OVER OBTAINING APGAR SCORE.

GUIDELINES FOR NEWBORN RESUSCITATION

Drying, warming, positioning, suction, tactile stimulation

Oxygen

Bag-Mask Ventilation

ChestCompressions

Medications

Go to the top of the page

Go to the Index