As required by law, as of October 1, 2014, all newborns are to be screened for Critical Congenital Heart Disease (CCHD) using pulse oximetry. The good news is that some hospitals in Utah are already screening for CCHD.
Pulse Oximetry Screening for Congenital Heart Disease: Toolkit
Utah birthing facilities will be provided with the following assistance:
- Basic Pulse Oximetry Screening Information
- Standardized protocols for CCHD Screening in the Well Baby Nursery and NICU
- Technical assistance for questions about screening policy or procedure
- Staff and parent education materials
Summary of Screening Recommendations
Screening
- All babies in the well-baby nursery should be screened with pulse oximetry for CCHD. Most babies in the NICU will be screened using a NICU CCHD screening protocol.
- The results of the pulse oximetry screening will be reported on the birth certificate.
- Pulse oximetry screening should not replace a complete history and physical exam.
- Screening should take place between 24 and 48 hours of life for healthy term babies. This may be delayed in NICUs if the infant is on oxygen. If early discharge is planned, screening should occur as late as possible prior to discharge.
- Screening should be done using the right hand and one foot, in parallel or in sequence.
- An adequate waveform should be observed before pulse oximetry measurement is recorded.
- Qualified personnel who have been educated in the use of the CCHD screening algorithm and trained in pulse oximetry monitoring of newborns should perform screening.
- Any failed screen requires complete clinical evaluation.
- Follow up of a failed screen should be initiated by the birth facilities upon obtaining failed screening result.
Equipment
- Screening should be done with motion tolerant pulse oximeters that report functional oxygen saturation.
- Pulse oximeters can be used with either disposable or reusable probes.
- Manufacture-recommended pulse oximeter-probe combinations should be used.
Communication
- Results of the newborn CCHD screening should be communicated to the newborn’s primary care provider.
- An appropriate mechanism should be established to ensure that the results of the pulse oximetry screening are recorded in the chart and are available to the infant’s primary care provider.
- Primary care providers will need to develop strategies for evaluating newborns who fail the CCHD screening.
- Health care providers must understand the rational for and limitations of pulse oximetry screening to detect CCHD.
Educate
- Provide education materials to inform parents of the pulse oximetry screening program, including information about limitations of the screening program and sources of more information.
Administration
- Each birthing facility should develop a policy for pulse oximetry screening that includes screening procedures, documentation, and reporting of results.
- Each birthing facility should establish a plan for management and evaluation of babieswho fail the CCHD screening.
- Each birthing facility should provide training in newborn pulse oximetry to individuals who will be involved in the screening process.
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