Assessing the Newborn

Assessing the Newborn

1. Apgar Scoring

   • Appearance (skin color)
     • Score of 0 — Blue or Pale
     • Score of 1 — Blue Extremities / Pink Body
     • Score of 2 — Pink All Over
   • Pulse (heart rate)
     • Score of 0 — Absent
     • Score of 1 — Below 100bpm
     • Score of 2 — More than 100bpm
   • Grimace (refelx irrability/response)
     • Score of 0 — No response
     • Score of 1 — Grimace
     • Score of 2 — Strong cry
   • Activity (muscle tone)
     • Score of 0 — None
     • Score of 1 — Weak, but shows flexion
     • Score of 2 — Strong motion
   • Respiration (breathing ability)
     • Score of 0 — Absent
     • Score of 1 — Weak, irregular
     • Score of 2 — Strong, normal crying

2. Physical Examination

   • General Observations
     • Weight
       • 3.2kg (for full-term babies)
       • Females: 3.5 kg (could range from 2.8 to 4.0 kg)
       • Males: 3.6 kg (could range from 2.9 to 4.2 kg)
     • Length
       • 20in / 51cm (could range from 19 to 21in)
     • Head Circumference
       • 14in / 35 cm (could range from 13 to 15in)
     • Abdominal Circumference
   • Vital Signs
     • Temperature
       • Stable body temperature
     • Pulse
       • 120 - 160bpm
     • Breathing
       • 40 - 60 breaths per minute
     • Systolic Blood Pressure
       • 60 to 90 mm Hg†
   • General Appearancee
     • Skin
       • Color
       • Texture
       • Pressence of Rashes
     • Head & Neck
       • Appearance
       • Shape
       • Fontanels
       • Cavicles
     • Face
       • Eyes (Red Reflex)
       • Ears (Shape and Size)
       • Nose
       • Cheeks
     • Mouth
       • Palate
       • Tongue
       • Throat
       • Check sucking reflex
     • Abdomen
       • Masses
       • Hernias
     • Arms & Legs
       • Movement
       • Development
       • Shape
       • Fingers
       • Palmar Creases
     • Genitals & Anus
       • Open passage
     • Lungs
       • Breathing sounds
       • Breathing patterns
     • Heart
       • Check for murmurs

3. Gestational Age Assessment

   • Physical Maturity
     • Skin Textures
       • Smooth
       • Sticky
       • Peeling
     • Lanugo
       • Absence on immature infants
       • Presence on mature infants
     • Plantar Creases
       • Absence of creases
       • Creases covering the entire foot
     • Breast
       • Thickness
       • Size
     • Eyes
       • Fused
       • Open
     • Ears
       • Amount of cartilage
       • Ear tissues’ stiffness
     • Genitals
       • Male
         • Presence of testes and appearance of scrotum
       • Female
         • Appearance and size of the clitoris and labia
   • Neuromuscular Maturity
     • Posture
       • Flexion of Arms and Legs
     • Square Window
       • Flexion of baby’s hands toward the wrist
     • Arm Recoil
       • How spring back the baby’s arms in a flexed position
     • Popliteal Angle
       • Range of how far the baby’s knees extend
     • Scarf Sign
       • How far the elbow can move across the baby’s chest
     • Heel to Ear
       • Distance between the foot and the head

4. Other Newborn Screen Tests

   • Heel Prick Test
     • Blood sample
   • Hearing Screen
     • Otoacoustic Emissions (OAE)
     • Auditory Brainstem Response (ABR)
   • Pulse Oximetry Testing
     • Blood oxygen levels