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The Apgar Score helped decrease the infant mortality rate

massivesci.com

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Re: The Apgar Score helped decrease the infant mortality rate

#21

Post by throwaway1239Mx »

https://www.newyorker.com/magazine/2006/10/09/the-score This is linked in OP, but gives very slightly more detail around how the score was actually popularized, and what Apgar's career looked like. (Plot twist, she wasn't "just" a practicing anesthesiologist, but the founder and head of a whole new Anesthesiology dept. at Columbia) I think the short version is that she published a paper in 1953, and managed to get obstetricians using the scale in a competitive spirit, but I am still curious about how it was marketed (just publishing a paper is rarely enough to get something publicized, afaik).

She also carried around a scalpel and tubing for giving passers-by emergency airways (tracheotomy?), and apparently did so over a dozen times.

Re: The Apgar Score helped decrease the infant mortality rate

#23

Post by sillyquiet »

tboyd47 wrote: post #7

> In the 1950s, reducing infant mortality (the death of an infant before their first birthday) was a daunting problem: an astonishing one in 30 newborns died at birth. > At that time, if a newborn didn’t seem to be thriving – if, for example, the baby’s skin was too blue or they were deemed too small – the baby would be left to die and documented as a stillborn. It sounds like the problem was that doctors were practi…

No, it sounds like you picked out a quote to make an edgy comment as you left out the very next sentence.

>Of course, it wasn’t that anyone wanted these babies to die, but doctors simply believed that they were too sick to survive.

i.e., they didn't want to prolong suffering.

Re: The Apgar Score helped decrease the infant mortality rate

#24

Post by carlmr »

darkerside wrote: post #15

Gamification is nothing new, and can have big impacts > Implementing the Apgar score introduced a spirit of competition because the doctors inherently wanted the newborns they delivered to have better scores.

Reading the responses of people here that survived with a score of 1/10 it really didn't matter what the score was. Only that it got doctors to compete to raise the score.

It's a bit sad though that doctors apparently just didn't try to do anything about it before.

Re: The Apgar Score helped decrease the infant mortality rate

#25

Post by mcrider »

unfocused wrote: post #19

I know this score too well. Our second child scored a 2/10, as he was not breathing. My heart nearly stopped. But the nurses were quick to get to work, and all is well now, years later. I think simple, quick assessment tools, allow fast, correct reactions - which in this scenario is an absolute must.

My daughter had the same score and experience two months ago. Scariest moment of my life -- But all is well now thanks to some amazing, fast moving doctors.

Re: The Apgar Score helped decrease the infant mortality rate

#26

Post by [deleted] »

sillyquiet wrote: post #23
tboyd47 wrote: post #7

> In the 1950s, reducing infant mortality (the death of an infant before their first birthday) was a daunting problem: an astonishing one in 30 newborns died at birth. > At that time, if a newborn didn’t seem to be thriving – if, for example, the baby’s skin was too blue or they were deemed too small – the baby would be left to die and documented as a stillborn. It sounds like the problem was that doctors were practi…

No, it sounds like you picked out a quote to make an edgy comment as you left out the very next sentence. >Of course, it wasn’t that anyone wanted these babies to die, but doctors simply believed that they were too sick to survive. i.e., they didn't want to prolong suffering.

[deleted]

Re: The Apgar Score helped decrease the infant mortality rate

#27

Post by tboyd47 »

sillyquiet wrote: post #23
tboyd47 wrote: post #7

> In the 1950s, reducing infant mortality (the death of an infant before their first birthday) was a daunting problem: an astonishing one in 30 newborns died at birth. > At that time, if a newborn didn’t seem to be thriving – if, for example, the baby’s skin was too blue or they were deemed too small – the baby would be left to die and documented as a stillborn. It sounds like the problem was that doctors were practi…

No, it sounds like you picked out a quote to make an edgy comment as you left out the very next sentence. >Of course, it wasn’t that anyone wanted these babies to die, but doctors simply believed that they were too sick to survive. i.e., they didn't want to prolong suffering.

I consider the idea of doctors deciding who lives and who dies to be applied eugenics.

"First, do no harm."

Maybe that's not how the situation really looked on the ground, but that's what the author of the piece presents to us, and it wouldn't be strange for that time, either.

Re: The Apgar Score helped decrease the infant mortality rate

#28

Post by fogleman »

BigQuery has a sample table, natality, that has all recorded births in the US from 1969 to 2008. It includes apgar_1min and apgar_5min fields.

https://cloud.google.com/bigquery/public-data

(Fun fact: I was actually able to find myself in the table based on my birthday, my birth state, my parent's ages and their birth states.)

Re: The Apgar Score helped decrease the infant mortality rate

#29

Post by kritiko »

cranekam wrote: post #6
bomdo wrote: post #3

Having recently had a child, I learned about APGAR and marveled how the emotional "is my baby ok" was put into a super easy process. The chart from the article can be followed by absolutely anyone and babies can be sent to specialists as needed - or not. As the article mentions, it may not get everything 100% right, but it's useful enough - and more importantly easy enough - to save a lot of lives. I can highly recom…

> I can highly recommend anyone to read about the process of medical emergency triage in general Any recommendations? I had a search about but didn't find anything much beyond basic explanations of the term.

Atul Gawande's Checklist Manifesto has some good discussions of complex care situations that are more or less driven by runbooks.
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