NOTE: In 1991 copies of the scale with instruction manual was available from Dr Celeste Marx, Department of Pediatrics, Rainbow Babies and Childrens Hospital, 2101 Adelbert Road, Cleveland, Ohio 44106.
Parameters:
(1) alertness
(2) calmness
(3) respiratory response
(4) movement
(5) mean arterial blood pressure
(6) heart rate
(7) muscle tone
(8) facial expression
where:
• mean arterial pressure = ((systolic BP in mm Hg) + (2 * (diastolic BP in mm Hg))) / 3
• The presence of sedation or coma would affect the scoring.
Point assignment
(1) Distress is indicated by 5 points.
(2) Normal responses show points that range from 1 to 4 points, with most being at 2 points.
(3) 1 point seems to be assigned for conditions ranging from coma to normal.
Performance:
• Inter-rater agreement was high.
• Internal consistency is high.
