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The Origins of the Apgar Score: How Did Virginia Apgar Change the History of Newborn Health Assessment?
At the moment a newborn is born, health professionals are faced with a crucial task: how to quickly and effectively assess the health status of the newborn? Apgar score is an innovative tool born out of this need. Since it was first proposed in 1952 by Virginia Apgar, an anesthesiologist at Columbia University, the Apgar score has become a widely used assessment method around the world to measure the performance of newborns 1 minute after birth. and 5 minutes of health status.
The history and development of Apgar fractions
A challenge Apgar faces is the lack of a standardized way to assess whether a newborn needs assisted breathing. After many revisions and improvements, she published the Apgar score at a meeting of the International Society for Anesthesia Research and the International Society of Anesthesiologists in 1952, and this result was later published in Anesthesia in 1953. & Analgesia ) journal. In 1955, Apgar and colleagues conducted a more in-depth study, using data from 15,348 infants to confirm the association between low Apgar scores (0-2 points) and characteristics of asphyxia.
The purpose of the Apgar score is to quickly determine whether a newborn needs immediate medical care, not to predict long-term health problems.
Grading criteria
The Apgar score determines a newborn's health by evaluating five criteria: activity (muscle tone), pulse, reflexes, appearance (skin color), and breathing. Each criterion is scored on a scale of 0 to 2, and the total score for the five criteria is 0 to 10. A high score usually means good health, while a low score may indicate the need for medical attention.
Interpretation and implementation of scores
The Apgar score of newborns is completed by team members including obstetricians, nurses and midwives. Typically, scoring is performed at 1 and 5 minutes after birth and is repeated at subsequent times if necessary. A score of seven and above is considered normal, a score of four to six is relatively low, and a score of three and below is generally considered a critical condition requiring immediate resuscitation measures.
A low one-minute score may indicate that the newborn needs medical care, but does not necessarily indicate long-term problems.
Limitations of Apgar scores
The Apgar score is not a perfect assessment tool. Its scores are affected by a variety of subjective factors, such as skin color, muscle tone and reflex responses. Particularly in premature infants, these scores may be low due to lack of maturity and not entirely as a result of asphyxia. In addition, there is variability in the consistency of scores between medical providers. One study pointed out that the consistency of scores between medical providers for the same infant was only 55% to 82%.
Although the Apgar score is a rapid and effective assessment tool, it should not be used inappropriately, as it may lead to misdiagnosis of symptoms such as suffocation.
Multicultural considerations
Research in recent years has found that babies from different ethnic backgrounds may face inequalities in scoring. Some studies indicate that non-white infants receive lower Apgar scores due to skin color, which may lead to unnecessary medical intervention.
Conclusion
The development of the Apgar score shows how Virginia Apgar advanced the standardization of newborn health assessment through advances in science and medicine. However, health care workers must maintain critical thinking when using this tool, taking into account its limitations and the diversity of cultural contexts. In the future, how to balance efficiency and fairness will become an issue that needs to be continuously explored in the field of neonatal care?
