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.
MisusePartially complete score and add the 5 to give the total values​​.
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 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
Copyright© openEHR Foundation
AuthorsAuthor name: Sam Heard
Organisation: Ocean Informatics
Email: sam.heard@oceaninformatics.com
Date originally authored: 2004-05-18
Other Details LanguageAuthor name: Sam Heard
Organisation: Ocean Informatics
Email: sam.heard@oceaninformatics.com
Date originally authored: 2004-05-18
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, 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, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=7BA2229E7FE5D5F604D62EA4CE0FDD42, build_uid=aa0536b9-e273-4e13-b8ab-1f7303192678, revision=1.0.1-alpha}
Keywordsnewborn, index, score, birth, infant, neonate, assessment
Lifecyclein_development
UIDf27fac48-3acb-4061-9619-c783fd8346ab
Language useden
Citeable Identifier1013.1.172
Revision Number1.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Clinical score derived from assessment of respiratory effort, heart rate, reflex irritability, muscle tone and skin colour., archetypeConceptComment=null, otherContributors=Paul Donaldson, Nursing Informatics Australia, Australia
Sebastian Garde, Ocean Informatics, Germany (Editor)
Anneke Goossen, Results 4 Care, Netherlands
Anne Harbison, CPCER, Australia
Sam Heard, Ocean Informatics, Australia
Omer Hotomaroglu, Turkey
Pieter Hummel, Medisch Centrum Alkmaar, Netherlands
Andrew James, University of Toronto, Canada
Heather Leslie, Ocean Informatics, Australia (Editor)
Ian McNicoll, Ocean Informatics, United Kingdom (Editor), 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
Finnish: Vesa Peltola, Tieto Finland
Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital, Bergen, Norway, MD, DEAA, specialist in anestesia and intensive care, Tropical medicin & MBA
Portuguese (Brazil): Jussara Rötzsch, OpenEHR Foundation, Medical Doctor, Psychiatrist, Clinical Modeler, OpenEHR Director, Coordinator of WG ehealth infostructure of brazilian e-health program
Arabic (Syria): Mona Saleh
Farsi: Shahla Foozonkhah, Ocean Informatics, Shahla.foozonkhah@oceanInformatics.com
Spanish (Chile): Sergio Carmona
Chinese (PRC): Lin Zhang, BIPH, linforest@163.com
Dutch: Marja Buur, Medisch Centrum Alkmaar, m.buur-krom@mca.nl, Erna Vreeke
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={details=[], identities=[], source=[], credentials=[], context=[], description=[], ism_transition=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003], code=at0003, itemType=POINT_EVENT, level=2, text=1 minute, description=Apgar score 1 minute after birth., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=[LOINC::48334-7 | 1 minute Apgar panel] (1 minute), values=Offset: 1 minute
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0026], code=at0026, itemType=POINT_EVENT, level=2, text=2 minute, description=Apgar score 2 minutes after birth., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=null, values=Offset: 2 minutes
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0027], code=at0027, itemType=POINT_EVENT, level=2, text=3 minute, description=Apgar score 3 minutes after birth., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=null, values=Offset: 3 minutes
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0028], code=at0028, itemType=POINT_EVENT, level=2, text=5 minute, description=Apgar score 5 minutes after birth., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=[LOINC::48333-9 | 5 minute Apgar panel] (5 minute), values=Offset: 5 minutes
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0031], code=at0031, itemType=POINT_EVENT, level=2, text=10 minute, description=Apgar score 10 minutes after birth., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=[LOINC::48332-1 | 10 minute Apgar panel] (10 minute), values=Offset: 10 minutes
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0037], code=at0037, itemType=EVENT, level=2, text=Any event, description=Apgar score at any additional time, as required., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], content=[], items=[], capabilities=[], other_participations=[], contacts=[], target=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003]/data[at0001]/items[at0009], code=at0009, itemType=ELEMENT, level=4, text=Respiratory effort, description=Observation of the infant's respiratory effort., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=[LOINC::32410-3 | 1 minute Apgar Respiratory effort] (1 minute)
[LOINC::32415-2 | 5 minute Apgar Respiratory effort] (5 minute)
[LOINC::32405-3 | 10 minute Apgar Respiratory effort] (10 minute), values=0: Absent [No effort to breath.]
[LOINC::LA6725]

1: Weak or irregular [Some effort to breath, moving chest.]
[LOINC::LA6726]

2: Normal [Breathing normally or crying.]
[LOINC::LA6727]

, 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=[LOINC::32407-9 | 1 minute Apgar Heart rate] (1 minute)
[LOINC::32412-9 | 5 minute Apgar Heart rate] (5 minute)
[LOINC::32402-0 | 10 minute Apgar Heart rate] (10 minute), values=0: Absent [No heart beat is seen, felt or heard.]
[LOINC::LA6716]

1: <100 beats per minute [Heart rate less than 100 beats per minute.]
[LOINC::LA6717]

2: ≥100 beats per minute [Heart rate greater than or equal to 100 beats per minute.]
[LOINC::LA6718]

, 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=[LOINC::32408-7 | 1 minute Apgar Muscle tone] (1 minute)
[LOINC::32413-7 | 5 minute Apgar Muscle tone] (5 minute)
[LOINC::32403-8 | 10 minute Apgar Muscle tone] (10 minute), values=0: Limp or flaccid [No spontaneous movement.]
[LOINC::LA6713]

1: Reduced tone [Some flexion of extremities.]
[LOINC::LA6714]

2: Normal tone [Normal, vigorous movements.]
[LOINC::LA6715]

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003]/data[at0001]/items[at0017], code=at0017, itemType=ELEMENT, level=4, text=Reflex irritability, description=Observation of the response of the infant to an irritant stimulation, for example, suctioning the oropharynx and nares with a soft rubber catheter., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=[LOINC::32409-5 | 1 minute Apgar Reflex irritability] (1 minute)
[LOINC::32414-5 | 5 minute Apgar Reflex irritability] (5 minute)
[LOINC::32404-6 | 10 minute Apgar Reflex irritability] (10 minute), values=0: No response [No response to stimulation.]
[LOINC::LA6719]

1: Reduced response [Grimace or feeble cry when stimulated.]
[LOINC::LA6720]

2: Normal response [Grimace, sneeze, cough or pulls away when stimulated.]
[LOINC::LA6721]

, 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=[LOINC::32406-1 | 1 minute Apgar Color] (1 minute)
[LOINC::32411-1 | 5 minute Apgar Color] (5 minute)
[LOINC::32401-2 | 10 minute Apgar Color] (10 minute), values=0: Completely blue [Body and extremities are blue.]
[LOINC::LA6722]

1: Body pink; extremities blue [Body is pink; extremities are blue.]
[LOINC::LA6723]

2: Completely pink [Body and extremities are pink; no cyanosis.]
[LOINC::LA6724]

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0002]/events[at0003]/data[at0001]/items[at0025], code=at0025, itemType=ELEMENT, level=4, text=Total, description=The sum of the 5 ordinal scores for each component parameter., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=[SNOMED-CT::169895004 | Apgar score at 1 minute (observable entity)] (1 minute)
[SNOMED-CT::169909004 | Apgar score at 5 minutes (observable entity)] (5 minute)
[SNOMED-CT::169922007 | Apgar score at 10 minutes (observable entity)] (10 minute)
[SNOMED-CT::364592005 | Component of Apgar score (observable entity)] (Any event)
[SNOMED-CT::249228009 | Total apgar score (observable entity)]
[LOINC::9272-6 | 1 minute Apgar Score] (1 minute)
[LOINC::9273-4 | 2 minute Apgar Score] (2 minute)
[LOINC::9274-2 | 5 minute Apgar Score] (5 minute)
[LOINC::9271-8 | 10 minute Apgar Score] (10 minute), values=min: >=0; max: <=10

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