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Cleansweep RN


  • Coined in the US as a mnemonic learning aid: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.
  • Named in honor of Dr. Virginia Apgar, anesthesiologist who pioneered in the care of newborn
  • A method of rapidly assessing the general state of a baby immediately after birth
  • A maximum of 2 points is given for each of the following signs
  • Usually measured at one minute and five minute after delivery
  • A low score on the one-minute test may show that the neonate requires medical attention
  • If the score remains below 3 for more than 30 minutes, there is a risk that the child will suffer longer-term neurological damage.

APGAR Scoring Chart






Heart Rate


Slow (<100)

(> 100beats)

Respiratory Effort


Slow, irregular, weak cry

Good, strong cry

Muscle Tone


Some flexion of extremities

Well flexed

Reflex Irritability

No response


Cry and withdrawal of foot


Blue, pale

Body pink, extremities blue

Completely pink

Interpretation of APGAR score:

  • 7 – 10 = Good
  • 4 – 6 = condition should be guarded; baby may need clearing of the airway and supplementary oxygen
  • 3 – 0 = baby is in serious danger and needs resuscitation

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