Re: OB: Apgar Revisited
From: Efrain Ramirez (eramirezt@coqui.net)
Fri Jul 16 07:45:12 2004
As I said -- they can be too subjective - one of the solutions --Cord
Gases.. :)
>At Fri, 16 Jul 2004, art fougner, md wrote:
>
>In this week's British Medical Journal -
>
>Correct use of the Apgar score for resuscitated and intubated newborn
>babies: questionnaire study
>
>Commentary
>
>The assessment of the Apgar score varied greatly among participants,
>particularly when scoring respiratory effort in intubated newborn
>babies. The original definition for scoring respiratory effort states
>that an apnoeic infant should score 0, and an infant who "breathed and
>cried lustily" should score 2.1 2 All other types of respiratory effort,
>such as irregular shallow ventilation, should score 1.1 2 We propose
>therefore that an infant who is apnoeic and requires intubation and
>ventilation should receive the minimum value of 0 for respiratory
>effort, not withstanding the fact that normoxia may be achieved through
>adequate artificial ventilation. If an infant requires artificial
>ventilation at birth due to irregular or shallow ventilation, he or she
>should score 1. To assess whether an artificially ventilated infant is
>apnoeic or not, ventilation should be stopped briefly, when possible, to
>check for the presence of spontaneous respiratory movements.
>
>Scores for colour and reflex irritability also varied widely. Although
>acrocyanosis (cases 1 and 3) should score 1, and a cry in response to a
>brisk tangential slap of the soles of the feet (case 1) should score 2,
>actual scores were incorrect in a third of cases.
>
>For the Apgar score to survive another 50 years, uniformity in scoring
>is paramount. Paediatric professionals should follow Apgar's original
>definitions more strictly, and consensus on scoring intubated newborn
>babies should be reached.
>
>http://bmj.bmjjournals.com/cgi/content/full/329/7458/143
>
>--
>art fougner, md
>ich bin ein New Yorker
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
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