ARCHETYPE Apgar score (openEHR-EHR-OBSERVATION.apgar.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.apgar.v1
ConceptApgar score
DescriptionClinical score derived from assessment of respiratory effort, heart rate, reflex irritability, muscle tone and skin colour.
UseAllows recording of an assessment of the state of a neonate explicitly as 1, 2, 3, 5 and/or 10 minute events after birth, plus additional events as required. Usual practice is to document the Apgar score at 1 and 5 minutes; further scores can be recorded as clinically indicated. It is possible to record the Apgar score at any time after birth using this archetype. Common clinical practice is to record all 5 parameters plus the total, however this archetype allows any partial information to be recorded, if that is all that is available eg from historical data. If the total is to be calculated, it is necessary for all 5 ordinal values to be recorded. The total is the sum of the five ordinal values (min 0, max 10). It is recognised that mnemonic learning aid for APGAR is commonly taught. For example, in English: A for Appearance (skin color), P for Pulse (heart rate), G for Grimace (reflex irritability), A for Activity (muscle tone), and R for Respiration. As this is not universally applicable for all languages, it is suggested that this mnemonic can be applied by renaming the data elements within templates if desired for a specific clinical scenario.
PurposeRecords the Apgar score as a simple, repeatable method to document the state of the newborn infant immediately after birth. The root time of the event series is always the birth.
ReferencesApgar V. A proposal of a New Method of Evaluation of the Newborn Infant. Curr Res Anesth Analg. 1953 Jul-Aug;32(4):260-7.

Apgar V, Holaday DA, James LS, Weisbrod IM, and Berrien C. Evaluation of the newborn infant; second report. J Am Med Assoc. 1958 Dec 13;168(15):1985-8.

Apgar V. The newborn (Apgar) scoring system. Pediatr Clin North Am. 1966 Aug;13(3):645-50.

Whaley LF, Wong DL (1979). Nursing Care of Infants and Children. St. Louis, Toronto, London, The C.V. Mosby Company.

http://en.wikipedia.org/wiki/Apgar_score

Apgar score, published archetype, openEHR Foundation. “www.openEHR.org/knowledge.” openEHR Clinical Knowledge Manager. Authored: 06 May 2009. http://www.openehr.org/knowledge/OKM.html#showArchetype_1013.1.172_10 (accessed May 31, 2011).
Copyright© openEHR Foundation
AuthorsAuthor name: Sam Heard
Organisation: Ocean Informatics
Email: sam.heard@oceaninformatics.com
Date originally authored: 18/05/2004
Other Details LanguageAuthor name: Sam Heard
Organisation: Ocean Informatics
Email: sam.heard@oceaninformatics.com
Date originally authored: 18/05/2004
OtherDetails Language Independent{references=Apgar V. A proposal of a New Method of Evaluation of the Newborn Infant. Curr Res Anesth Analg. 1953 Jul-Aug;32(4):260-7. Apgar V, Holaday DA, James LS, Weisbrod IM, and Berrien C. Evaluation of the newborn infant; second report. J Am Med Assoc. 1958 Dec 13;168(15):1985-8. Apgar V. The newborn (Apgar) scoring system. Pediatr Clin North Am. 1966 Aug;13(3):645-50. Whaley LF, Wong DL (1979). Nursing Care of Infants and Children. St. Louis, Toronto, London, The C.V. Mosby Company. http://en.wikipedia.org/wiki/Apgar_score Apgar score, published archetype, openEHR Foundation. “www.openEHR.org/knowledge.” openEHR Clinical Knowledge Manager. Authored: 06 May 2009. http://www.openehr.org/knowledge/OKM.html#showArchetype_1013.1.172_10 (accessed May 31, 2011)., MD5-CAM-1.0.1=B5F002DA0EBFCE43780E1656946CE455}
Keywordsnewborn, index, score, birth, infant, neonate, assessment, Apgar, baby
LifecycleAuthorDraft
Language useden
Citeable Identifier1013.1.172
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Margaret Cotter, AMSANT, Australia
Paul Donaldson, Queensland Health, Australia
Michelle Dowden, Miwatj Health Ngalkanbuy Health, Australia
Tim Garden, NTG Department of Health, Australia
Sebastian Garde, Ocean Informatics, Germany
Anneke Goossen, Netherlands
Anne Harbison, Australia
Sam Heard, Ocean Informatics, Australia (Editor)
Omer Hotomaroglu, Turkey
Pieter Hummel, Netherlands
Andrew James, University of Toronto, Canada
Bernadette Lack, Department of Health, NT, Australia
Heather Leslie, Ocean Informatics, Australia (Editor)
Ian McNicoll, Ocean Informatics, Scotland
Jeremy Oats, NT Health, Australia
Gary Sinclair, NT DoH, Australia
Cherie Whitbread, Royal Darwin Hospital, Australia
Jo Wright, NT Dept of Health, Australia, originalLanguage=en, translators=German: Jasmin Buck, Sebastian Garde, Thilo Schuler, University of Heidelberg, Central Queensland University, Ocean Informatics
Russian: Igor Lizunov, i.lizunov@infinnity.ru
Spanish (Chile): Sergio Carmona
Dutch: Marja Buur, Medisch Centrum Alkmaar, m.buur-krom@mca.nl, Erna Vreeke
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1: Weak or irregular [Some effort to breath, moving chest.]
2: Normal [Breathing normally or crying.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003]/data[at0001]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Heart Rate, description=Recording of the infant's heart rate., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent [No heart beat is seen, felt or heard.]
1: <100 beats per minute [Heart rate less than 100 beats per minute.]
2: ≥100 beats per minute [Heart rate greater than or equal to 100 beats per minute.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003]/data[at0001]/items[at0013], code=at0013, itemType=ELEMENT, level=4, text=Muscle tone, description=Observation of the infant's muscle tone., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Limp or flaccid [No spontaneous movement.]
1: Reduced tone [Some flexion of extremities.]
2: Normal tone [Normal, vigorous movements.]
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1: Reduced response [Grimace or feeble cry when stimulated.]
2: Normal response [Grimace, sneeze, cough or pulls away when stimulated.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003]/data[at0001]/items[at0021], code=at0021, itemType=ELEMENT, level=4, text=Skin colour, description=Observation of the skin colour of the infant., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Completely blue [Body and extremities are blue.]
1: Body pink; extremities blue [Body is pink; extremities are blue.]
2: Completely pink [Body and extremities are pink; no cyanosis.]
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