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					1.2 APGAR Score / DAY 1 & 2
The following article is background advice for expecting mothers taken from the
website created by the Hospital for Sick Children. This and other information can
easily be obtained from the aboutkidshealth website at the following url:

Your newborn baby will go through a
number of assessments when he is first
born, to make sure that he is in good
health. His first assessments, called the
Apgar score, occur when he is just one
minute and five minutes old.
This assessment, developed by anaethetist
Virginia Apgar in 1952, is a scoring system
that assesses newborn babies’ well-being
using five different factors: heart rate,
breathing, muscle tone, reflexes, and skin
colour. The newborn baby is given a score
between 0 and 2 for each factor, and the
highest possible score is 10. Scores are
rarely higher than 9 out of 10. Below is a
table of what the doctors look for when assessing the Apgar score.
Factor          Score 0               Score 1                     Score 2

Heart rate      No heart rate         Below 100 beats/min         Above 100 beats/min

Breathing       No breathing          Slow and irregular          Good

Muscle tone Limp and loose             Some flexing of arms       Actively moving
                                      and legs

Reflexes        No reflex             Grimaces or frowns       Vigorously cries when
               responses              when                     reflexes are
                                      reflexes are stimulated stimulated

Colour          Blue and pale          Body is pink but hands     Entire body is pink
                                      and feet
                                       are blue

The reason the Apgar score is checked at one and five minutes is to give an idea of
how well the newborn baby is doing following birth and whether his condition is
improving or not. A newborn baby who scores between 4 and 7 needs careful
monitoring at regular intervals, and possible treatment. A newborn baby with a score
less than 4 would need resuscitation.
1.2 APGAR Score (continued)
Apgar scores are assessments of the newborn baby at the time of the scoring. They
are generally not useful predictors for future problems. Initially low Apgar scores do
not tell the whole story. At birth, many rapid changes are taking place which need
only a few minutes or hours to resolve themselves. A newborn baby who is having
some trouble breathing in the first few minutes of life may only need time to clear his
lungs of amniotic fluid and might be breathing normally once this natural process has
Chances are that the Apgar score, physical examination, and other tests will show
that your newborn baby is in good health. However, if these tests show that there is a
medical problem, he may need to be transferred to a special nursery where a
paediatrician will look after your baby. If the problem is more serious, your newborn
baby might be transferred to a hospital with a neonatal intensive care unit (NICU)
with paediatricians called neonatologists who specialize in the care of newborn
babies. They will take care of your newborn baby and do the best they can to
improve his health.

A composite score that is a measure of each of the following components for a
newborn baby: 1) heart rate, 2) breathing effort, 3) muscle tone, 4) colour, and 5)
reflex responses. Each component is given a rating between 0 and 2, with 0
being poor function and 2 being excellent function. The maximum possible rating
is 10.
1.5 Apgar Score Cards

Individual Students Score Cards

                                  Reflex    Heart              Muscle Total
APGAR Time Interval     Colour                       Breathing
                                 Response Rate/Pulse            Tone  Score
1 Minute
5 Minutes
10 Minutes
20 Minutes
Mean Score

Class Consolidation Set
(Based on 10 students participating)

Student         1 Minute      5 Minute    10 Minute   20 Minute   Average
                  Score         Score       Score       Score      (Mean)
                 (Day 1)       (Day 1)     (Day 2)     (Day 2)      Score
2.1 Measures of Central Tendency
Given the following formulas and templates:

    1. Fill in the definitions in the appropriate spaces for the Measures of Central Tendency.

        Mean: _______________________________________________________

        Median: _____________________________________________________

        Mode: _______________________________________________________

        Weighted Mean: ________________________________________________________

            w x        i       i

         xw  w  i

                    i

Complete the table using the values from the data score cards gathered during the APGAR Simulation
Classes to calculate the weighted mean for each of the scores. Weight should reflect the relative
importance placed on the 1 and 5 minute readings (3 times and 2 times the importance) of the 10 and
20 minute readings.

Weighted Mean Score Cards

                                     Weight                Mean
APGAR Time Interval                                                               wi xi
                                      wi                    xi
1 Minute
5 Minutes
10 Minutes
20 Minutes
Totals (∑)

(Hint: Use the totals in the formula above to calculate the weighted mean.)

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