Newborn Assessment in the First Hour

By VeriScorePrep Team · 5 min

The first hour of life is when many life-threatening problems surface. A systematic newborn assessment separates normal transition from pathology.

APGAR

Scored at 1 and 5 minutes (and at 10 if 5-minute score is low). Five components, each 0–2: Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (tone), Respiration. A score of 7–10 is reassuring; lower scores need intervention and continued assessment.

Normal findings

• Acrocyanosis (blue hands/feet only) is normal.
• Respiratory rate 30–60/min without distress.
• Heart rate 100–160/min.
• Capillary refill ≤2 seconds.

Report immediately

• Central cyanosis (lips, tongue).
• Grunting, nasal flaring, retractions (respiratory distress).
• APGAR score <7 at 5 minutes.
• Heart rate <100 or >160.
• Poor tone or absent reflexes.

Other assessments

Check for passing of meconium/urine, intact palate, normal femoral pulses (absent suggests coarctation), and bonding/feeding initiation.