APGAR Score
Rapidly assesses newborn clinical status at 1 and 5 minutes after birth to guide resuscitation decisions
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Scoring type
- point sum
- Care settings
- Emergency department, ICU, Inpatient
When it activates
Scribeable activates a calculator from the encounter. The APGAR Score can activate when the transcript or pasted chart context documents any of these:
- Newborn delivery assessment
- Neonatal resuscitation evaluation
- Birth documentation
- C-section delivery
- Post-delivery neonatal status
Note-type scope: it activates on notes whose subject resolves to obgyn. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Skin color: 0=blue/pale, 1=body pink/extremities blue, 2=completely pink | exam | ||
| Heart rate: 0=absent, 1=<100 bpm, 2=>=100 bpm | vital | ||
| Reflex irritability: 0=no response, 1=grimace, 2=cry/active withdrawal | exam | ||
| Muscle tone: 0=limp, 1=some flexion, 2=active motion | exam | ||
| Respiratory effort: 0=absent, 1=slow/irregular, 2=good cry | exam |
Scoring
5 components (Appearance, Pulse, Grimace, Activity, Respiration), each scored 0-2. Total 0-10. Assessed at 1 minute and 5 minutes; continue every 5 minutes if score <7.
Appearance Skin color: 0=blue/pale, 1=body pink/extremities blue, 2=completely pink + Pulse Heart rate: 0=absent, 1=<100 bpm, 2=>=100 bpm + Grimace Reflex irritability: 0=no response, 1=grimace, 2=cry/active withdrawal + Activity Muscle tone: 0=limp, 1=some flexion, 2=active motion + Respiration Respiratory effort: 0=absent, 1=slow/irregular, 2=good cry (each 0-2)
Interpretation
7-10: Normal, routine care. 4-6: Moderately depressed — stimulation, airway clearance, possible PPV. 0-3: Severely depressed — immediate resuscitation (PPV, compressions, medications as indicated). 5-minute score <7: continue scoring every 5 minutes to 20 minutes. Low 5-minute score correlates with neonatal mortality; 10-minute score <5 associated with cerebral palsy risk.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: AAP/ACOG.
- Apgar V. A proposal for a new method of evaluation of the newborn infantApgar (Newborn Score) 1953 · 1953 · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the APGAR Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a APGAR Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
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