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Quiz: How well do you know the APGAR score?

The APGAR score is considered the standard in newborn evaluation


Newborn babies are evaluated using the APGAR test.


By Megan Wells, EMS1 Contributor

This test was developed by Virginia Apgar, a Professor at Columbia University College of Physicians and Surgeons, in 1952. The test works by identifying five factors that would assess the newborn’s wellbeing and assigns them a score. The sum of all five factors is the infant’s overall score. A high score would indicate a normal adjustment to life outside the womb, while a low one indicates that the infant may need additional assistance in early life. How well do you know the rubric? Take the test to find out.

As a recap, the five factors are:

  • Appearance – 0 for blue or gray skin tone; 1 for normal, or pink, skin tone with blue extremities; 2 for normal everywhere
  • Pulse – 0 for no pulse; 1 at less than 100 beats per minute; 2 for over 100 beats per minute
  • Grimace (reflex response) – 0 for no response; 1 for a facial movement with stimulation; 2 when pulling away, sneezing, coughing or crying with stimulation
  • Activity – 0 with no muscle tone (loose and floppy); 1 with some muscle tone; 2 when there is active motion
  • Respiration – 0 with no respirations, 1 with slow or irregular breaths and weak cry; 2 with a normal rate and strong cry

Initially, Dr. Apgar took these measurements within the first minute of life, but standard practice today also takes another measurement at 5 minutes. A score of 7, 8, or 9 is considered normal.

An APGAR score test can be valuable in determining whether the infant needs help adjusting to the outside world. Examples of interventions would include the administration of oxygen or physical stimulation. This test is not meant to diagnose long-term health problems or predict the future health of the child.