Advanced Medical Life Support

Front 1

Signs and Symptoms of Acute Myocardial Infarction

Back 1

Obstruction of coronary artery by clot or thrombus. Signs and symptoms or the same as Acute Coronary Syndrome.
Sudden onset of chest pain, often described as pressure and heaviness. Radiates to arm and/or jaw. Also likely to have shortness of air, diaphoresis, pale, mottled, cool skin, weakness, lightheaded, nausea, vomiting, and or impending feeling of doom.

Front 2

Treatment of Acute Myocardial Infarction

Back 2

The acronym MONA is often used to remind us of treatment.
Morphine, Oxygen, Nitro, ASA. Not particular in order. Oxygen and ASA are the only two prehospital treatments to show improve survival rates.

Front 3

Signs and Symptoms of Anaphylaxis

Back 3

Hypersensitivity response with hypotensive, dyspnea, wheezing, rales, rhonchi, anxiety, urticaria, and pruritus which can begin within mins up to 1 hour after exposure. Can cause distributive shock with peripheral vasodilation and relative hypovolemia.

Front 4

Treatment of Anaphylaxis

Back 4

Remove allergen and reverse effects. ABCs, epinephrine, corticosteroids, and benadryl. Epi binds with Alpha and Beta receptors increasing BP, heart rate, and bronchodilation. Benadryl blocks H1 providing relief of symptoms.

Front 5

Signs, Symptoms and Treatment of Angina Pectoris

Back 5

Chest pain 2nd to inadequate blood supply from a narrowed coronary artery blockage. Stable angina comes and goes with exercise or stress, and only last 3 to 5 mins, possibly up to 15 mins. Relieved by rest or nitro. Unstable lasts longer than usual, often occurs at rest, and may be caused by coronary spasms. May lead to AMI.
Treatment is same as AMI, CAS, in prehospital with MONA.

Front 6

Signs and Symptoms of Appendicitis

Back 6

Pain localized to right lower quadrant or right lower back. Pain classically begins in the periumbilical region than becomes more localized to RLQ and worse. Positive psoas sign or stratching increases pain. Other signs are fever, nausea, and vomiting.
Treatment prehospital includes pain control and antimetics.

Front 7

Signs, Symptoms and Treatment of Asthma

Back 7

Dyspnea, wheezing or absent lung sounds, chest tightness, cough, signs URI such as rhinorrhea, congestion, headache, pharyngitis, and myalgia.
Treatment include inhaled Beta agonist such as Albuterol or Xopenex, subQ epi, and corticosteroids. Mag Sulfate has been shown to control severe exacerbations of asthma given very slowly causing relax smooth bronchial muscles.

Front 8

Signs, Symptoms, and Treatment of Bowel Obstruction

Back 8

Crampy abdominal pain, constipation or diarrhea, inability to pass flatus, distended abdomen, absent or high-pitched bowed sounds. No specific treatment for bowel obstruction prehospital.

Front 9

Signs and Symptoms of Carbon Monoxide Poisoning

Back 9

Depends on concentration and duration of exposure. Typical signs and symptoms are fatigue, headache, myalgia, nausea, voming, shortness of air, syncopal, ataxia, seizures, alter level of consciousness, coma, death. Cherry red skin is a late sign, pallor is more common.

Front 10

Treatment of Carbon Monoxide Poisoning

Back 10

Most important is immediate removal of patient from environment. High-flow oxygen along with standard treatment. The higer FIO2 decreases the half life of carbon monoxide. Pt may be hypotensive, give fluid bolus via IV.
They will require hyperbaric oxygen chamber depending on severity.

Front 11

Signs and Symptoms of Cardiac Tamponade

Back 11

When fluid accumulates inside the layered pericardial sac arround the heart. This causes compression forces around the heart and restricts heart cause obstructive shock. Can be caused by trauma or medical condition.
Signs and Symptoms are remember with Beck's Triad:
Low BP 2nd to low cardiac output, JVD, and muffled heart tones. Often have chest pain and dyspnea, possibly with a cough. Along with signs of shock.

Front 12

Treatment of Cardiac Tamponade

Back 12

Prehospital includes basic management, follow chest pain protocol, but hold anything that would lower BP. Fluid bolus can buy time.
They willl need a pericardiocentesis to remove fluid.

Front 13

Signs and Symptoms of Chicken Pox(varicella)

Back 13

Fever, malaise, anorexia and headache. The patient will develop a rash or itchy blisters. Treatment is standard. Pt may have antiviral, corticosteroids, and antihistamines PRN.

Front 14

Signs and Symptoms of COPD

Back 14

Chronic bronchitis or loss of alveolar surface area associated with emphysema.
Signs and symptoms include dyspnea, wheezing to absent lung sounds, cough possibly productive, intolerance of exertion, and chest discomfort. Cigarette smoking is primary cause of COPD. Same treatment as Asthma. Consider CPAP as needed.

Front 15

Signs, Symptoms, and Treatment of Clostridium Difficile

Back 15

Otherwise know as C-Diff is a direct result of antibiotic therapy, which suppresses the normal flora in the GI tract allowing C diff to predominate.
Treatment is to stop unnecessary antibiotic treatment. May need Flagyl or Vancocin for 10 days.

Front 16

Signs and Symptoms of Cocaine Overdose

Back 16

Tachycardia, dysrhythmias, hyper or hypotensive, tachy or hyperpnea, MI, pallor or cyanosis, hyperexcitability and anxiety, headache, hyperthermia, diaphoresis, N/V/D, dilated but reactive pupils, confusion, delirium, halluncinations, seizures, coma, death.

Front 17

Treatment of Cocaine Overdose

Back 17

Swab nose to remove residual if cocaine was snorted. Standard treatment. Be ready for erratic or violent behavior. Higher risk for cardiac ishemia and hypothermia.

Front 18

Signs and Symptoms of Cyanide Poisoning

Back 18

Anxiety, bradycardia followed by tachycardia, hypertension followed by hypotension, dysrhythmias, bitter almond odor to breath, cherry red mucus membranes, nausea, dyspnea, headache, dizziness, dilated pupils, confusion, seizure, coma, death.

Front 19

Treatment of Cyanide Poisoning

Back 19

Supportive care for anxiety, hyperventilation.
Antidotes for more severe including Amyl nitrite IV, Sodium nitrite IV, & Sodium thiosulfate IV. May need gastric lavage and/or hyperbaric oxygen.

Front 20

Signs and Symptoms of Deep Frostbite

Back 20

Superficial frostbite includes numbness, paresthesia, poor fine motor control, pruritus (itching), and edema. With deep frostbite includes hemorrhagic blisters, diminished range of motion, mottled gray area, hard or immobile tissue.

Front 21

Treatment of Deep Frostbite

Back 21

Primarily supportive, along with protecting extremity. Do not allow pt to use extremity, example walk on it. Remove jewelry and wet clothing. Cover with blanket. Rapid rewarming is not recommended prehospital because of the risk of refreezing.

Front 22

Signs and Symptoms of Diabetic Ketoacidosis

Back 22

Insulin deficiency and excessive glucagon levels combine to create hyperglycemia, acidotic, volume depleted state. Pt is very dehydrated, polyphagia, polydipsia, and polyuria. Signs of shock-like tachycardia, tachypnea, shallow breathing, and orthostatic changes.
Nausea, vomiting, abdominal pain, fruity breath odor, fatigue/weakness, altered LOC, seizure, coma, death.

Front 23

Treatment of Diabetic Ketoacidosis

Back 23

Mostly supportive care prehospital. They need insulin therapy to definitively treat. Pt does usually require 3 to 6 liters of fluid during initial resuscitation so 2 large bore IVs is recommended for severe cases.

Front 24

Signs, Symptoms, and Treatment of Ectopic Pregnancy

Back 24

Implantation of fertilized icing egg outside of the uterus. Vaginal bleeding with or without abdominal pain, may put pt into shock.
Prehospital treatment is supportive, may require surgical intervention.

Front 25

Signs, Symptoms, and Treatment of Encephalitis

Back 25

Encephalitis is general inflammation of the brain that causes focal or diffuse brain dysfunction. Signs and syptoms are similar to meningitis including fever, nausea, vomiting, lethargy, headache, and stiff neck. Key findings are alteration in brain function including disorientation, behavior change, motor or sensory deficits.
Treatment is standard, antivirals are usually given at the ER. ICP may be treated with diuresis, mannitol, and/or steroids.

Front 26

Signs, Symptoms, and Treatment of Epidural Hematoma

Back 26

Accumulation of blood between the inner table of the skull and the dura matter, the outer most meninges. Usually caused by trauma.
Head trauma, headache, nausea, vomiting, unilateral dilated pupil fixed or slow to react to light, dizziness, weakness, alter LOC.
Treatment standard with emphasis on spinal immobilization and not increasing ICP.

Front 27

Signs, Symptoms, and Treatment of Epiglottitis

Back 27

Infection causing inflammation of the epiglottis and supraglottic region.
Begins with sore throat processing to pain with swallowing and muffled voice. Difficulty bleeding, fever, drooling, and stridor.
Treatment should be supportive. Intubation is likely to be difficult so it should be last resort. Usually positive pressure ventilation is successful. Pt will need antibiotics.

Front 28

Signs, Symptoms, and Treatment of Gastrointestinal Bleed

Back 28

Signs of shock, loss of blood, syncopal, tachycardia, hypotension, weakness, confusion, with or without abdominal pain.
Treatment supportive prehospital.

Front 29

Signs, Symptoms, and Treatment of H1N1 Influenza

Back 29

Flu symptoms sudden onset fever, chills, weak, and body aches. H1N1 symptoms include diarrhea. Pts can worsen with respiratory distress, chest pain, alter LOC, etc.
Prehospital treatment is supportive. Pt may receive antiviral drug therapy.

Front 30

Signs, Symptoms, and Treatment of Hyperosmotic Hyperglycemic Non-Ketotic Syndrome (HHNK)

Back 30

High blood sugar causing dehydration and decline mental status, often progressing to a coma. Other signs and symptoms are fever, nausea, vomiting, abdominal pain, tachycardia, tachypnea, seizures, and hypotension.
Treatment is standard with emphasis on fluid bolus for dehydration.

Front 31

Signs, Symptoms, and Treatment of Hypoglycemia

Back 31

Low blood glucose. Diaphoresis, alter LOC, tremors, tachycardia, pale, cold, clammy skin. If not treated leads to seizures and alter LOC.
Treatment is oral glucose or dextrose IV. Glucagon IM if no IV.

Front 32

Signs, Symptoms, and Treatment of Malaria

Back 32

A mosquito-borne infectious disease of humans and other animals. Symptoms of malaria include fever, shivering, arthralgia (joint pain), vomiting, anemia (caused by hemolysis), hemoglobinuria, retinal damage, and convulsions. The classic symptom of malaria is cyclical occurrence of sudden coldness followed by rigor and then fever and sweating lasting four to six hours.
Prehospital treatment is supportive pt will need drug therapy for a full recovery.

Front 33

Signs, Symptoms, and Treatment of Meningitis

Back 33

Meningitis is inflammation of the meninges which surround the brain and spinal cord. The CSF will show signs of infection. Can be caused by infectious and non-infectious disease but common life threat is bacterial infection. CSF lacks white blood cells or antibodies so infection goes uncontrolled.
Classic symptoms include headache, nuchal rigidity, fever and chills, and photophobia. Can also cause seizures, alter LOC, coma, and death.
Treatment is standard ABC, oxygen, IV, EKG, etc. IV antibiotics and steroids will be given at hospital once diagnosis is definitive.

Front 34

Signs and Symptoms of Mild and Moderate Hypothermia

Back 34

Mild hypothermia includes shiver vigorously along with dizziness, lethargy, nausea, and weakness. May also include hyperventilation and tachycardia.
With moderate hypothermia clinical signs of deterioration become apparent with bradypnea and bradycardia, alter LOC, and diuresis.

Front 35

Treatment of Mild and Moderate Hypothermia

Back 35

Most cases will resolve with passive rewarming (warm environment, out of wet clothing, etc). Warm fluid hydration is ok but avoid caffine beverages due to their diuretic effects.

Front 36

Signs and Symptoms of Severe Hypothermia

Back 36

Alter LOC, bradypnea, bradycardia, hypotension, ventricular arrhythmias with J wave present. Usually unconscious with dilated to minimally responsive pupils. Pt is very susceptible to V-Fib and cardiac arrest.

Front 37

Treatment of Severe Hypothermia

Back 37

Stabilize ABCs. With palpable pulse avoid abrupt movement and gently move patient. Without a pulse emphasis is on compressions as meds and defibrillation will have limited effects at this temp.

Front 38

Signs and Symptoms of Mononeucleosis

Back 38

Mononucleosis is a viral infection causing fever, sore throat, and swollen lymph glands, especially in the neck.

Mononucleosis, or mono, is often spread by saliva and close contact. It is known as "the kissing disease," and occurs most often in those age 15 to 17. However, the infection may develop at any age.

Mono is usually linked to the Epstein-Barr virus (EBV), but can also be caused by other organisms such as cytomegalovirus (CMV).
Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. The lymph nodes in the neck are frequently swollen and painful.

A pink, measles-like rash can occur and is more likely if you take the medicines ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive Strep test.)

Symptoms of mononucleosis include:
Drowsiness
Fever
General discomfort, uneasiness, or ill feeling
Loss of appetite
Muscle aches or stiffness
Rash
Sore throat
Swollen lymph nodes, especially in the neck and armpit
Swollen spleen

Front 39

Signs, Symptoms, and Treatment of Pancreatitis

Back 39

An inflammatory process in which premature activation of pancreatic enzymes causes the pancreas to begin to digest itself, resulting in pain and necrosis as inflammation spread. Typical signs and symptoms are constant midepigastric pain radiates to the back. Generally not exacerbated by eating. Cullen's sign, a blue discoloration around umbilicus, and Grey Turner sign, a blue discoloration around the flanks, may be present. May also have fever, nausea, and vomiting. Can lead to shock.
Treatment is mainly supportive prehospital with pain control.

Front 40

Signs, Symptoms, and Treatment of Pneumonia

Back 40

Lung infection causing fluid to collect in the alveoli.
Can cause, fever, chills, cough (often productive), malaise, nausea vomiting, chest pain, dyspnea, tachypnea, tachycardia, and abnormal breath sounds inculding rales, rhochi, and even wheeze.
Treatment is mainly supportive with oxygen at rate needed. Severe dyspnea consider CPAP to alleviate need for intubatio. Patient may need hydration and will need antibiotics at ED.

Front 41

Signs and Symptoms of Pneumothorax/Tension Pneumothorax

Back 41

Gas in the pleural cavity which is usually filled with a small amount of fluid which lubricated the pleura to minimize friction. Can be spontaneously or by trauma IE positive pressure ventilation.
Causes tachypnea, tachycardia, pulsus paradoxus (weak or no pulse during inspiration), decreased or absent breath sounds especially unilateral, hypoxia, cyanosis, JVD, and alter LOC.

Front 42

Treatment of Pneumothorax/Tension Pneumothorax

Back 42

Supportive if patient is stable.
Thoracostomy (Thoracentesis) if unstable.
2nd intercostal space above the third rib of affected side. Needle should be at least 2 inches long.

Front 43

Treatment of Seizure

Back 43

Place padding and remove hazards. Oxygen especially during seizure if possible as pt breathing stops or is ineffective during seizure, providing ventilaiton.
During postictal state, supportive care is the best treatment. They may be hostile, be patient.
Start IV and give benzodiazepines per protocol.
Pay special attention to EKG initially because V-Tach can mimic seizure like activity.

Front 44

Signs, Symptoms, and Treatment of Sepsis

Back 44

Massive systemic inflammatory response to infection.
Two are more must be present for diagnosis of systemic inflammatory response syndrome (SIRS):
Temp above 100F (38C) or below 97F (36C)
heart rate above 90bpm
resp rate above 20 or PaCO2 less than 32
High White Blood count

Septic shock also include hypotension with tachycardia.
IV bolus PRN to increase BP & decrease heart rate
hospital tx include blood work and abx

Front 45

Signs and Symptoms of Stroke

Back 45

Presentation can differ drastically base on area of brain effected.
Key findings are unilateral facial droop, unilateral weakness, speech disturbances, lack of balance/vertigo, and altered mental status.

Front 46

Treatment of Stroke

Back 46

Transport to a Stroke Center. Fibrinolytic agents can be given within 3 hours(some stroke centers use up to 4 and half hours) of last time patient know to be normal.
Best position is supine with head slightly elevated if ischemic stroke is suspected. Do not over heat patient as hyperthermia accelerates ischemic brain injury. Seizure meds and ASA may be used per medical control.

Front 47

Signs, Symptoms, and Treatment of Tuberculosis

Back 47

Bacterium infecting lungs causing persistent cough for 2 or 3 weeks, night sweats, headache, weight loss, hemoptysis, and chest pain.
TB infection means exposure to TB.
TB disease means they have TB.
Use droplet precaution, oxygen PRN, pt will need antimycobacterial drugs.

Front 48

Identitfy the complications of meningitis

Back 48

Pt may have seizures, treat per protocol. Be ready to and control airway with alter LOC.

Front 49

Identify the etiologies and classifications of obstructive shock

Back 49

Cardiac tamponade, PE, tension pneumo.
Cardinal sign decrease BP, SOA, tachycardia, tachypnea, JVD, decreased breath sounds, muffled heart tones.
Supportive tx, needle decompression for pneumo.

Front 50

Identify the etiologies and classifications of distributive shock

Back 50

Neurogenic, Anaphylactic, Septic, Toxins
they have different cardinal signs, tx cause.

Front 51

Describe the stages of shock

Back 51

Compensatory-normal BP, slight tachycardia, tachypnea, decrease cap refill, cool hands and feet, pale mucus membrane, restless anxiety.
Decompensated-BP decrease, tachycardia above 120bpm, tachypnea 30 to 40 bpm. Cool, clammy skin, pale dynastic mucous membrane, weakness, metabolic acidosis, decrease pulses.
Irreversible-profound hypotension, lactate above 8.

Front 52

Compare and contrast the signs and symptoms and treatment for hypoglycemia, hyperglycemia (DKA) and HHNS

Back 52

DKA commonly causes altered LOC, metabolic acidosis, cause Kussmaul's tachypnea.
Hyperosmolar hyperglycemic nonketotic syndrome is similar has less profound altered LOC.

Front 53

Define and give examples of various types of abdominal pain

Back 53

Visceral-hollow organs are stretch, deep persistent ache, cramping, burning. Difficult to locate.
Somatic-irritation of nerve fibers, deep tissues. Easier to pinpoint. Tender to application, guarding, rebound tenderness.

Front 54

Identify the components of AMLS pathways it relates to patient assessment

Back 54

The success of the AMLS pathway depends on taking an efficient, comprehensive history and obtaining and correctly interpreting information from the physical examination and diagnostic assessments. Together with the patient's history, physical exam, risk factors, cardinal presentation suggest a possible diagnosis.

Front 55

Discuss the importance of the AMLS Pathway and identifying and managing life threats

Back 55

The cardinal presentation must be identified and the primary survey performed initially so that any life-threatening medical emergencies can be identified and managed without delay.

Front 56

Discuss the importance of the medical history as it relates to AMLS Pathway

Back 56

Part of a thorough assessment and often done before secondary exam. This helps get the whole picture. With the history and can determine risk factors and work for a working diagnosis.

Front 57

Most common means of prevention and transmission of infection diseases

Back 57

Standard Precautions, which are to be used on all patients.
-Hand hygiene
-PPE
-Sharps and disposal practices
-Cleaning

Front 58

Identify communication barriers that affect obtaining thorough medical history

Back 58

Communication barriers include cultural differences, hearing impairment, and safety concerns. Experience and patience is the key to over coming the communication barriers.

Front 59

Signs and symptoms of gastroenteritis

Back 59

Watery diarrhea, nausea and vomiting, mild abdominal pain, low grade fever. Easily transmissible. Antimetics, IV fluid.

Front 60

Identify the signs/symptoms and treatment of salicylate poisoning

Back 60

Common med is ASA.
Early signs and symptoms gastric irritation and pain, may develop metabolic acidosis. Supportive care, consider fluids, bicarb, and airway management.

Front 61

Describe the components of the Cushing's Triad

Back 61

Systolic HTN, bradycardia, irregular respirations.
Triad means increased ICP.

Front 62

SMASHED

Acute Mental Status Changes

Back 62

Substrates, Meningitis/Mental Ilness, Alcohol, Seizure/Stimulants, Hypo/Hyper, Electrolytes/Encephalopathy, Drugs

Front 63

AEIOU-TIPS

Decreased LOC

Back 63

Alcohol/Anaphylaxis/Acute MI, Epilepsy/Endocrine Abnormality/Electrolytes, Insulin, Opiates, Uremia, Trauma, Intracranial/Infection, Poisoning, Seizure

Front 64

SNOT

Initial Assessment of AMS

Back 64

S- Sugar, Stroke, Seizure

N- Narcosis (CO2, Opiates)

O- Oxygen

T- Trauma, Toxins, Temp

Front 65

Common Migraine Triggers

Back 65

Stress, Illness, Physical activity, Changes in sleep patterns, High altitude or barometric changes, Skipping meals, Meds, Caffeine, Alcohol, Bright lights, Loud noises, Unpleasant odors

Front 66

Indicators of imminent respiratory failure

Back 66

RR >30 or <6

O2 less than 90

Multiple accessory muscle groups

Inability to lie supine

HR >140

AMS

Inability to clear own airway secretions

Cyanosis of nail beds, lips

Front 67

Pulmonary Hx Assessment

Back 67

Fever, chills, ankle edema, calf swelling or tenderness, back pain, chest pain, ab pain, vomiting, orthopnea, cough, dyspnea on exertion, history of COPD or asthma, blood in sputum, prior respiratory admissions, hx of smoking, prior intubations, home O2 or neb

Front 68

Criteria to Establish Ventilation

Back 68

PaO2 <55 mm Hg

PaCO2 > 50

pH< 7.32

Front 69

DOPE

Acute deterioration of intubated patient

Back 69

Displacement, Obstruction, Pneumothorax, Equipment failure

Front 70

Kussmaul's Respiration

Back 70

Hypertachypneic, hyperpneic respiration that points towards metabolic acidosis, particularly DKA.

Front 71

Cheyne-Stokes Respiration

Back 71

Apnea alternating with tachypnea in crescendo-decrescendo sequence, suggesting injury to resp. center of brainstem

Front 72

Biot's Respiration

Back 72

Characterized by groups of quick, shallow resps followed by regular or irregular periods of apnea. May be caused by opiod overdose or injury to medulla oblongata.

Front 73

Apneustic Respiration

Back 73

Deep, gasping breaths with pause at full inspiration, followed by incomplete release suggests injury to or infection of pons or upper medula. Or ketamine sedation.

Front 74

Ataxic Respiration

Back 74

Disorganized pattern and depth, often progresses to apnea. Damage to medulla oblongata.

Front 75

Vasoconstricting Medications

Back 75

Epinephrine, Norepinephrine, Dopamine, Phenylephrine, Vasopressin

Front 76

Inotropic Medications

Back 76

Dopamine, Dobutamine, Epinephrine, Isoproterenol, Norepinephrine

Front 77

Most Common S&S of PE

Back 77

Tachypnea, Shortness of Breath, Chest Pain, Cough, Hemoptysis

Front 78

SLUDGE BBM

Organophosphate and Carbamate Poisoning

Back 78

Salivation, Lacrimation, Urination, Defecation, GI Distress, Emesis, Bradycardia, Bronchoconstriction, Miosis

Front 79

DUMBBELS

Muscarinic Effects of Organophosphate and Carbamate Poisoning

Back 79

Diarrhea, Urination, Miosis, Bradycardia, Bronchorrhea, Emesis, Lacrimation, Salivation

Front 80

MTWThF

Nicotinic Effects of Organophosphate and Carbamate Poisoning

Back 80

Muscle weakness/paralysis, Tachycardia, Weakness, Hypertension, Fasciculations

Front 81

Glascow Coma Scale

Back 81

Eye Opening- 4

Verbal Response- 5

Motor Response- 6

Total Score- 15

Comatose- 8 or less

Unresponsive- 3 or less

Front 82

Rule of 9's Adult

Back 82

Head- 9

Chest- 9

Stomach- 9

Leg- 9 (back) (front)

Entire Arm- 9

Front 83

Rule of 9's Infant

Back 83

Head- 18

Chest and belly- 18

Entire Arm- 9

Entire Leg- 14

Genitals- 1

Front 84

APGAR Chart

Back 84

Activity- 2 points (active)

Pulse- 2 points (over 100)

Grimace- 2 points (response to stimulation)

Appearance- 2 points (pink)

Respiration- 2 points (loud cry)

Front 85

APGAR Abbreviation

Back 85

Activity

Pulse

Grimace

Appearance

Respiration