Bedside newborn assessment at 1 and 5 minutes — score 0/1/2 for each of Appearance, Pulse, Grimace, Activity and Respiration. Live calculation with interpretation and resuscitation prompts. Runs locally in your browser.
Disclaimer: This calculator is a clinical decision support aid, not a substitute for clinical judgment. APGAR is a description of the newborn's transition, not an indication for or response to resuscitation — never delay positive-pressure ventilation while waiting to assign a score. If 5-minute APGAR is < 7, the AAP/ACOG recommendation is to continue scoring every 5 minutes up to 20 minutes. Always document the breakdown alongside the total.
7–10: reassuring transition, routine care. 4–6: moderately depressed — stimulate, dry, position the airway, give positive-pressure ventilation if the heart rate is < 100 and respiration is inadequate. 0–3: severely depressed — initiate full NRP resuscitation immediately (PPV, chest compressions and medications as per algorithm).
If the 5-minute APGAR is < 7, continue scoring every 5 minutes up to 20 minutes (AAP/ACOG 2015). An "extended" APGAR table should also record what interventions are in place (oxygen, CPAP, PPV, intubation, chest compressions, adrenaline) at each time point — the raw score in isolation under-reads a baby who is being actively resuscitated.
A persistently low APGAR (≤ 3 at 5 minutes or beyond) is associated with higher mortality and cerebral palsy risk, but is neither sensitive nor specific for hypoxic-ischaemic encephalopathy. Cord pH, base deficit, the neurological examination and the clinical course remain more useful for prognosis and for HIE / cooling decisions.
Preterm babies often score lower for tone and reflex irritability for maturational reasons alone, so a low APGAR in a preterm infant must be interpreted with caution. An intubated baby cannot cry — score the respiratory component on the adequacy of the underlying respiratory effort or document with the intervention noted (extended APGAR).
Compatible with NRP, IAP and NNF documentation practice in Indian labour rooms and SNCUs. Always record the component breakdown and any active resuscitation at each time point.
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