Hi I don't know why anyone would bother with 10 minute ROUTINE Apgar scoring. It's a screening test, not a diagnostic test. Admittedly the 5 minute one is a fairly good predictor of whether or not asphyxia occurred in utero but it is not a good predictor of longterm outcomes including cerebral palsy. Ten minutely Apgar scores are sometimes used to indicate if the neonate is responding to active resuscitation (but there are better ones). I'm not sure where the quality co-ordinator is getting her/his evidence from but there is plenty of good research to back up the list's claims about the usefulness of Apgar scoring and perhaps that is the best place for 'quality' people to base their protocols on rather than trying to prevent litigation with more assessments of dubious worth.
Even arterial and venous pH levels and/or base deficits aren't very good predictors about longterm outcomes for most babies although there is a tendency to use them routinely for 'defensive or just in case I get sued medicine reasons'. Golly no wonder the health system is broke. For healthy newborns breast feeding is far more useful. A baby that can cry and sucks at the breast soon after birth is si in all likelihood not asphyxiated and is cheerfully making the transition to life in the big world. So in terms of quality auditing a more meaningful assessment is to write that the infant sucked well at the breast 'cause a compromised babe can't suck. Why do so many people try to make such a normal event as birthing so abnormal? Sometimes I think midwifery is quickly becoming little more than a series of multiple assessments which are carefully documented on an ever increasing array of forms - probably at least 10 times in ten different places. The irony of it all is that most of it is quite meaningless. Carol -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
