Jurdi et al reported the Neonatal Resuscitation and Adaption Score (NRAS) for evaluating a newborn. This can be used as an alternative to the Apgar Score. The authors are from Virginia Commonwealth University.
Patient selection: newborn (delivery room)
Parameters:
(1) heart rate (C1)
(2) cardiovascular support (C2)
(3) reflex response (palmar grasp) (N1)
(4) supplemental oxygen (R1)
(5) respiratory support (R2)
Parameter
Finding
Points
heart rate
absent
0
1 to 99 beats per minute
1
>= 100 beats per minute
2
cardiovascular support
no response to chest compression
0
heart rate improves to > 60 bpm after chest compression
1
no compression needed
2
reflex response
none
0
incomplete grasp
1
complete grasp
2
supplemental oxygen
> 40%
0
22 to 40%
1
room air (21%)
2
respiratory support
positive pressure ventilation with no spontaneous effort
0
CPAP or positive pressure ventilation with irregular spontaneous effort
1
none require
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A low NRAS is associated with worse outcomes.
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