Question: is pulse ox screening for children law?

 and any other relevant information such as research studies. SUMMARY
Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for congenital heart disease (CHD) in newborns. It uses a light source and sensor (probe) to measure oxygen in the blood. Last year, the Advisory Committee on Heritable Diseases in Newborns and Children, which advises the federal Health and Human Services (HHS) secretary, recommended that pulse oximetry screening for CHD be added to the uniform screenings for newborns. Citing “evidence gaps,” the HHS secretary did not adopt the recommendation. But an interagency coordinating committee on newborn screening is further examining the issue and should be submitting a plan to the HHS secretary shortly. The American Heart Association (AHA) views pulse oximetry testing of newborns as an effective and inexpensive tool to assist in diagnosing CHD. A large scale study recently performed in the United Kingdom supports pulse oximetry screening for newborns. The United States has not had a study of comparable size to date. Three states (New Jersey, Maryland, and Indiana) have passed legislation requiring pulse oximetry screening of all newborns.

and any other relevant information such as research studies. SUMMARY
Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for congenital heart disease (CHD) in newborns. It uses a light source and sensor (probe) to measure oxygen in the blood. Last year, the Advisory Committee on Heritable Diseases in Newborns and Children, which advises the federal Health and Human Services (HHS) secretary, recommended that pulse oximetry screening for CHD be added to the uniform screenings for newborns. Citing “evidence gaps,” the HHS secretary did not adopt the recommendation. But an interagency coordinating committee on newborn screening is further examining the issue and should be submitting a plan to the HHS secretary shortly. The American Heart Association (AHA) views pulse oximetry testing of newborns as an effective and inexpensive tool to assist in diagnosing CHD. A large scale study recently performed in the United Kingdom supports pulse oximetry screening for newborns. The United States has not had a study of comparable size to date. Three states (New Jersey, Maryland, and Indiana) have passed legislation requiring pulse oximetry screening of all newborns.

 But an interagency coordinating committee on newborn screening is further examining the issue and should be submitting a plan to the HHS secretary shortly. The American Heart Association (AHA) views pulse oximetry testing of newborns as an effective and inexpensive tool to assist in diagnosing CHD. A large scale study recently performed in the United Kingdom supports pulse oximetry screening for newborns. The United States has not had a study of comparable size to date. Three states (New Jersey, Maryland, and Indiana) have passed legislation requiring pulse oximetry screening of all newborns. The Maryland law will not be implemented until there are federal recommendations for such screening. Other states are currently considering such legislation. BACKGROUND
The following information is from the Children's National Medical Center in Washington, D.C.
What is Congenital Heart Disease? CHD is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns.

But an interagency coordinating committee on newborn screening is further examining the issue and should be submitting a plan to the HHS secretary shortly. The American Heart Association (AHA) views pulse oximetry testing of newborns as an effective and inexpensive tool to assist in diagnosing CHD. A large scale study recently performed in the United Kingdom supports pulse oximetry screening for newborns. The United States has not had a study of comparable size to date. Three states (New Jersey, Maryland, and Indiana) have passed legislation requiring pulse oximetry screening of all newborns. The Maryland law will not be implemented until there are federal recommendations for such screening. Other states are currently considering such legislation. BACKGROUND
The following information is from the Children's National Medical Center in Washington, D.C.
What is Congenital Heart Disease? CHD is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns.

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf
 Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
November 30, 2012
Albany, NY
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
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Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
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Governor Andrew M. Cuomo today announced the signing of legislation that will require birthing facilities such as general hospitals and clinics to screen newborns for congenital heart defects through pulse oximetry screening, also known as pulse ox. The condition, which affects the structure and function of a newborns heart, is present in nearly one percent of live births each year, and is the leading cause of infant death due to birth defects, according to the federal Centers for Disease Control and Prevention (CDC). Adding this screening to the required list of examinations by birthing facilities has the potential to save more newborn lives. It is heartbreaking when a parent loses their child to a condition that could have been easily detected and appropriately treated, Governor Cuomo said. This law will prevent the number one cause of infant death due to birth defects by requiring hospitals and clinics to screen newborns for congenital heart defects increasing early detection of this condition so that we can take quick action to save the lives of our children. I am proud to sign this bill, which will dramatically improve newborn care in New York, and I thank the bill sponsors, Senator Larkin and Assemblywoman Gunther, for their work. According to the CDC, approximately 7,200 babies born each year have critical congenital heart defects (CCHDs), which represents about 25 percent of CHDs. CCHDs account for nearly 30 percent of all deaths of infants under the age of one year and in other infants, they can lead to serious physical or developmental disabilities. Senator Bill Larkin, who sponsored the Senate bill, said, This simple, cost effective screening will allow doctors to detect potentially fatal heart defects in newborns and take the necessary steps to ensure they receive proper treatment before problems occur. I commend the Governor for signing this legislation into law and for protecting infants across New York State.

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf
 Assemblywoman Aileen Gunther, who sponsored the Assembly bill, said, When a family is expecting a baby there is so much to be excited about - the nursery, baby clothes, the safest car seat, the best stroller. But there is one critical detail that cant be overlooked: a simple check of the babys heart health. Im proud to have sponsored the pulse ox bill. Pulse ox is simple, painless and more importantly could save a babys life. All babies deserve a healthy start with a healthy heart. Pulse oximetry screening, which tests the amount of oxygen in a newborns blood, can detect many CHDs and most types of CCHDs, which often are not identified through other screening methods for CHD, such as prenatal ultrasounds and routine newborn physical examinations. The screening is non-invasive and painless. It is conducted by attaching sensors to a babys hand and foot between 24 and 48 hours of his or her birth. If oxygen levels are too low, additional tests would then be conducted to detect any potential heart defects that may be present in the baby.

Assemblywoman Aileen Gunther, who sponsored the Assembly bill, said, When a family is expecting a baby there is so much to be excited about - the nursery, baby clothes, the safest car seat, the best stroller. But there is one critical detail that cant be overlooked: a simple check of the babys heart health. Im proud to have sponsored the pulse ox bill. Pulse ox is simple, painless and more importantly could save a babys life. All babies deserve a healthy start with a healthy heart. Pulse oximetry screening, which tests the amount of oxygen in a newborns blood, can detect many CHDs and most types of CCHDs, which often are not identified through other screening methods for CHD, such as prenatal ultrasounds and routine newborn physical examinations. The screening is non-invasive and painless. It is conducted by attaching sensors to a babys hand and foot between 24 and 48 hours of his or her birth. If oxygen levels are too low, additional tests would then be conducted to detect any potential heart defects that may be present in the baby.

 Pulse ox was invented in the 1970s and is now widely used and accepted in clinical care; it is often thought to be a basic vital sign. Why
is pulse ox used to screen for CHD? Pulse ox can help to identify infants with critical CHD that may have low levels of oxygen in their blood. Pulse ox screening may help diagnose critical CHD before an infant becomes sick. Who
should be screened? All infants should be screened. When
should screening be performed? Pulse ox screening should be performed before discharge from the nursery, after the infant turns 24 hours of age. If the infant was born prematurely, screening should be performed when medically appropriate.

Pulse ox was invented in the 1970s and is now widely used and accepted in clinical care; it is often thought to be a basic vital sign. Why
is pulse ox used to screen for CHD? Pulse ox can help to identify infants with critical CHD that may have low levels of oxygen in their blood. Pulse ox screening may help diagnose critical CHD before an infant becomes sick. Who
should be screened? All infants should be screened. When
should screening be performed? Pulse ox screening should be performed before discharge from the nursery, after the infant turns 24 hours of age. If the infant was born prematurely, screening should be performed when medically appropriate.

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf
 I am haunted by the thought that this might not have happened in the doctors office, and we might not have our lively 2-year-old with us today. Id like to thank Governor Cuomo for signing this law so that hopefully no other family will ever have this worry. Dr. Jennifer L. Howse, March of Dimes President, said, Since March of Dimes grantee Dr. Robert Guthrie's development of the first newborn screening for phenylketonuria (PKU) in Buffalo fifty years ago, New York State has been a pioneer and leader in newborn screening. New York should be commended for continuing to maintain a robust newborn screening panel and testing infants for over 40 inherited conditions, including all 31 conditions listed on the U.S. Department of Health and Human Services Recommended Uniform Screening Panel. Passage of this law is a fitting tribute to the March of Dimes 75th anniversary. Krystal Peters, a March of Dimes Mission Mom who lost her daughter following heart surgery, is also a parent who has advocated for this legislations passage. Today is an especially important milestone for March of Dimes mission parents who have suffered personal tragedy due to undiagnosed CCHD, Peters said. Babies are dying every day from undetected heart defects, but we have the knowledge and power to prevent CCHD from taking their lives so soon. Knowing that New York State has mandated a law requiring the 'pulse ox' test to be added to newborn screening means saving lives and spreading awareness. It means hope.

I am haunted by the thought that this might not have happened in the doctors office, and we might not have our lively 2-year-old with us today. Id like to thank Governor Cuomo for signing this law so that hopefully no other family will ever have this worry. Dr. Jennifer L. Howse, March of Dimes President, said, Since March of Dimes grantee Dr. Robert Guthrie's development of the first newborn screening for phenylketonuria (PKU) in Buffalo fifty years ago, New York State has been a pioneer and leader in newborn screening. New York should be commended for continuing to maintain a robust newborn screening panel and testing infants for over 40 inherited conditions, including all 31 conditions listed on the U.S. Department of Health and Human Services Recommended Uniform Screening Panel. Passage of this law is a fitting tribute to the March of Dimes 75th anniversary. Krystal Peters, a March of Dimes Mission Mom who lost her daughter following heart surgery, is also a parent who has advocated for this legislations passage. Today is an especially important milestone for March of Dimes mission parents who have suffered personal tragedy due to undiagnosed CCHD, Peters said. Babies are dying every day from undetected heart defects, but we have the knowledge and power to prevent CCHD from taking their lives so soon. Knowing that New York State has mandated a law requiring the 'pulse ox' test to be added to newborn screening means saving lives and spreading awareness. It means hope.

 August 18, 2011

2011-R-0293
PULSE OXIMETRY SCREENING OF NEWBORNS

By: John Kasprak, Senior Attorney
You asked for information on pulse oximetry screening of newborns for congenital heart disease. You are interested in basic information about the procedure; its costs, including equipment and provider time; other states'activities in requiring such screening; and any other relevant information such as research studies. SUMMARY
Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for congenital heart disease (CHD) in newborns. It uses a light source and sensor (probe) to measure oxygen in the blood. Last year, the Advisory Committee on Heritable Diseases in Newborns and Children, which advises the federal Health and Human Services (HHS) secretary, recommended that pulse oximetry screening for CHD be added to the uniform screenings for newborns. Citing “evidence gaps,” the HHS secretary did not adopt the recommendation.

August 18, 2011

2011-R-0293
PULSE OXIMETRY SCREENING OF NEWBORNS

By: John Kasprak, Senior Attorney
You asked for information on pulse oximetry screening of newborns for congenital heart disease. You are interested in basic information about the procedure; its costs, including equipment and provider time; other states'activities in requiring such screening; and any other relevant information such as research studies. SUMMARY
Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for congenital heart disease (CHD) in newborns. It uses a light source and sensor (probe) to measure oxygen in the blood. Last year, the Advisory Committee on Heritable Diseases in Newborns and Children, which advises the federal Health and Human Services (HHS) secretary, recommended that pulse oximetry screening for CHD be added to the uniform screenings for newborns. Citing “evidence gaps,” the HHS secretary did not adopt the recommendation.

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf
 I am proud to sign this bill, which will dramatically improve newborn care in New York, and I thank the bill sponsors, Senator Larkin and Assemblywoman Gunther, for their work. According to the CDC, approximately 7,200 babies born each year have critical congenital heart defects (CCHDs), which represents about 25 percent of CHDs. CCHDs account for nearly 30 percent of all deaths of infants under the age of one year and in other infants, they can lead to serious physical or developmental disabilities. Senator Bill Larkin, who sponsored the Senate bill, said, This simple, cost effective screening will allow doctors to detect potentially fatal heart defects in newborns and take the necessary steps to ensure they receive proper treatment before problems occur. I commend the Governor for signing this legislation into law and for protecting infants across New York State. Assemblywoman Aileen Gunther, who sponsored the Assembly bill, said, When a family is expecting a baby there is so much to be excited about - the nursery, baby clothes, the safest car seat, the best stroller. But there is one critical detail that cant be overlooked: a simple check of the babys heart health. Im proud to have sponsored the pulse ox bill. Pulse ox is simple, painless and more importantly could save a babys life.

I am proud to sign this bill, which will dramatically improve newborn care in New York, and I thank the bill sponsors, Senator Larkin and Assemblywoman Gunther, for their work. According to the CDC, approximately 7,200 babies born each year have critical congenital heart defects (CCHDs), which represents about 25 percent of CHDs. CCHDs account for nearly 30 percent of all deaths of infants under the age of one year and in other infants, they can lead to serious physical or developmental disabilities. Senator Bill Larkin, who sponsored the Senate bill, said, This simple, cost effective screening will allow doctors to detect potentially fatal heart defects in newborns and take the necessary steps to ensure they receive proper treatment before problems occur. I commend the Governor for signing this legislation into law and for protecting infants across New York State. Assemblywoman Aileen Gunther, who sponsored the Assembly bill, said, When a family is expecting a baby there is so much to be excited about - the nursery, baby clothes, the safest car seat, the best stroller. But there is one critical detail that cant be overlooked: a simple check of the babys heart health. Im proud to have sponsored the pulse ox bill. Pulse ox is simple, painless and more importantly could save a babys life.

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf
 Krystal Peters, a March of Dimes Mission Mom who lost her daughter following heart surgery, is also a parent who has advocated for this legislations passage. Today is an especially important milestone for March of Dimes mission parents who have suffered personal tragedy due to undiagnosed CCHD, Peters said. Babies are dying every day from undetected heart defects, but we have the knowledge and power to prevent CCHD from taking their lives so soon. Knowing that New York State has mandated a law requiring the 'pulse ox' test to be added to newborn screening means saving lives and spreading awareness. It means hope. This legislation adding CCHD screening through pulse oximetry to the list of conditions that birthing facilities are required to test will take effect in 180 days. When it does, New York will join nearly half of the states in the U.S. that now require this kind of screening. The movement to include this screening was accelerated in September 2011, when the United States Department of Health and Human Services recommended that pulse oximetry screening for CCHDs be added to its list of recommended screening tests for newborns. Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
Download
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
Download
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Russian.pdf
Download
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Haitian Creole.pdf
Download
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings French.pdf
Download
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Korean.pdf
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08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Italian.pdf
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 PULSE OXIMETRY SCREENING OF NEWBORNS
PULSE OXIMETRY SCREENING OF NEWBORNS
Location: JUVENILES; MEDICAL CARE; Scope: Other States laws/regulations; August 18, 2011

2011-R-0293
PULSE OXIMETRY SCREENING OF NEWBORNS

By: John Kasprak, Senior Attorney
You asked for information on pulse oximetry screening of newborns for congenital heart disease. You are interested in basic information about the procedure; its costs, including equipment and provider time; other states'activities in requiring such screening;

PULSE OXIMETRY SCREENING OF NEWBORNS
PULSE OXIMETRY SCREENING OF NEWBORNS
Location: JUVENILES; MEDICAL CARE; Scope: Other States laws/regulations; August 18, 2011

2011-R-0293
PULSE OXIMETRY SCREENING OF NEWBORNS

By: John Kasprak, Senior Attorney
You asked for information on pulse oximetry screening of newborns for congenital heart disease. You are interested in basic information about the procedure; its costs, including equipment and provider time; other states'activities in requiring such screening;

The probe does not puncture the skin and the measurement can usually be read in 30 to 60 seconds. Why is Pulse Oximetry Used to Screen for CHD? Pulse oximetry is used to measure how much oxygen is in the blood. It is a routinely used test that can be used to monitor a baby's oxygen level during a procedure or treatment and can also be helpful in determining if a baby's heart and lungs are healthy. Pulse oximetry can also help to identify babies with serious heart problems due to low levels of oxygen in their blood. A health care provider may ask for more testing (such as an ultrasound of the heart or an echocardiogram) when a low pulse oximetry reading is identified. Who Should be Screened and When Will the Test be Done? According to the Children's National Medical Center, all babies in the newborn nursery who are not already thought to have CHD should be screened. The pulse oximetry test should be performed when a baby is older than 24 hours. What is a Normal Reading?

The probe does not puncture the skin and the measurement can usually be read in 30 to 60 seconds. Why is Pulse Oximetry Used to Screen for CHD? Pulse oximetry is used to measure how much oxygen is in the blood. It is a routinely used test that can be used to monitor a baby's oxygen level during a procedure or treatment and can also be helpful in determining if a baby's heart and lungs are healthy. Pulse oximetry can also help to identify babies with serious heart problems due to low levels of oxygen in their blood. A health care provider may ask for more testing (such as an ultrasound of the heart or an echocardiogram) when a low pulse oximetry reading is identified. Who Should be Screened and When Will the Test be Done? According to the Children's National Medical Center, all babies in the newborn nursery who are not already thought to have CHD should be screened. The pulse oximetry test should be performed when a baby is older than 24 hours. What is a Normal Reading?

 Pulse oximetry testing before discharge may be one important strategy for such screening as it can be an effective, noninvasive, inexpensive tool to assist in diagnosing critical congenital heart disease. While the risk for use of this screening is minimal, and the benefits are still being fully elucidated, the AHA reaffirms its current recommendation supporting consideration of pulse oximetry as a screening methodology (Class IIA-Level of Evidence C)1based on consensus science versus extensive randomized controlled trials. RECENT UNITED KINGDOM STUDY
In one of the largest studies of its kind, United Kingdom researchers have demonstrated that pulse oximetry testing of newborns improves the detection of critical congenital heart disease, identifying defects that go undetected with antenatal ultrasound. The study, published in Lancet this month, involved the pulse oximetry screening, between February 2008 and January 2009, of 20,055 apparently healthy newborns from six maternity units across the United Kingdom. Of the total number of babies, 53 had major congenital heart disease (24 critical), a prevalence of 2.6 per 1000 live births. Pulse oximetry detected 75% of the critical cases and 49% of all major congenital heart defects. Lead author of the study Dr. Andrew Ewer stated that “pulse oximetry is a better more sensitive test than antenatal ultrasound and physical exam, although we are not suggesting we should replace those, but rather include pulse-ox as an additional screening tool, which would allow us to identify the majority of babies with critical congenital heart disease.” For a link to the study go to: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60753-8/fulltext
ACTIVITY IN OTHER STATES
New Jersey was the first state to require that eve

Pulse Oximetry Pulse Oximetry
Pulse Oximetry
Contact Us
 Pulse oximetry is a simple, non-invasive and painless test that is used to measure the percent of oxygen saturation of hemoglobin in the arterial blood and the pulse rate. The pulse-oximetry test was invented in the 1970s and is now widely used and accepted in clinical care. In fact, it is often considered a vital sign. Traditionally, pulse oximetry has been used to monitor an individual’s oxygen saturation during acute and chronic illness, as well as during procedures requiring general anesthesia or sedation. Why is Pulse Oximetry Used to Screen for CHD? A routine physical examination, as performed during the first 24 hours of life in most institutions, is only 50 percent effective in detecting CHD. The pulse-oximetry test can help identify infants with low levels of oxygen in their blood and may help diagnose critical CHD before an infant becomes sick. The test has been recommended as a screening test for critical CHD by the: U.S. Department of Health and Human Services
American Heart Association
American Academy of Pediatrics
American College of Cardiology
It is important to note, however, that it is possible for a baby with CHD to have a normal pulse-oximetry reading. CHD cannot be completely ruled out by a normal pulse-oximetry reading.

Pulse Oximetry

Pulse Oximetry
Pulse Oximetry
Contact Us

Pulse oximetry is a simple, non-invasive and painless test that is used to measure the percent of oxygen saturation of hemoglobin in the arterial blood and the pulse rate. The pulse-oximetry test was invented in the 1970s and is now widely used and accepted in clinical care. In fact, it is often considered a vital sign. Traditionally, pulse oximetry has been used to monitor an individual’s oxygen saturation during acute and chronic illness, as well as during procedures requiring general anesthesia or sedation. Why is Pulse Oximetry Used to Screen for CHD? A routine physical examination, as performed during the first 24 hours of life in most institutions, is only 50 percent effective in detecting CHD. The pulse-oximetry test can help identify infants with low levels of oxygen in their blood and may help diagnose critical CHD before an infant becomes sick. The test has been recommended as a screening test for critical CHD by the: U.S. Department of Health and Human Services
American Heart Association
American Academy of Pediatrics
American College of Cardiology
It is important to note, however, that it is possible for a baby with CHD to have a normal pulse-oximetry reading. CHD cannot be completely ruled out by a normal pulse-oximetry reading.

  Performing Pulse Oximetry (Pulse Ox) with the Infant Patient: EDUCATION FOR PROVIDERS
EDUCA
TION

FOR

PROVIDERS

Pulse

Ox

–

DOs

Pulse

Ox

–

DON’Ts

 Pulse

Ox

-

CAUTION! The

pulse

is

needed

to

determine

the

oximetry

reading. Pulse

ox

is

not

accurate

if

the

patient

is

coding

or

is

having

a

cardiac

arrhythmia. Remember: No

pulse,

no

oximetry! Pulse

ox

readings

are

not

instantaneous. The

oximetry

reading

that

is

displayed

on

the

monitor

is

an

average

of

readings

over

the

past

few

seconds. childrenscolorado.org/CCHDScreening
p: 720-777-6820

 Performing Pulse Oximetry (Pulse Ox) with the Infant Patient: EDUCATION FOR PROVIDERS
EDUCA
TION

FOR

PROVIDERS

Pulse

Ox

–

DOs

Pulse

Ox

–

DON’Ts

Pulse

Ox

-

CAUTION! The

pulse

is

needed

to

determine

the

oximetry

reading. Pulse

ox

is

not

accurate

if

the

patient

is

coding

or

is

having

a

cardiac

arrhythmia. Remember: No

pulse,

no

oximetry! Pulse

ox

readings

are

not

instantaneous. The

oximetry

reading

that

is

displayed

on

the

monitor

is

an

average

of

readings

over

the

past

few

seconds. childrenscolorado.org/CCHDScreening
p: 720-777-6820

Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Governor Cuomo Signs Legislation to Require Congenital Heart Defect Screenings for Newborns
Translations
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Chinese.pdf
08.01.13.rel_.Legislation to Require Congenital Heart Defect Screenings Spanish.pdf
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 All babies deserve a healthy start with a healthy heart. Pulse oximetry screening, which tests the amount of oxygen in a newborns blood, can detect many CHDs and most types of CCHDs, which often are not identified through other screening methods for CHD, such as prenatal ultrasounds and routine newborn physical examinations. The screening is non-invasive and painless. It is conducted by attaching sensors to a babys hand and foot between 24 and 48 hours of his or her birth. If oxygen levels are too low, additional tests would then be conducted to detect any potential heart defects that may be present in the baby. Melissa Berlin of Gloversville, a volunteer with the American Heart Association, is one of the hundreds of parents that helped push for the legislation. We were discharged from the hospital with a healthy baby boy. Yet, at his well-baby visit one week later, Colton began to turn blue. We were rushed to the emergency room, where we learned that he had a congenital heart defect, said Berlin. He has already had two out of three scheduled open heart surgeries.

All babies deserve a healthy start with a healthy heart. Pulse oximetry screening, which tests the amount of oxygen in a newborns blood, can detect many CHDs and most types of CCHDs, which often are not identified through other screening methods for CHD, such as prenatal ultrasounds and routine newborn physical examinations. The screening is non-invasive and painless. It is conducted by attaching sensors to a babys hand and foot between 24 and 48 hours of his or her birth. If oxygen levels are too low, additional tests would then be conducted to detect any potential heart defects that may be present in the baby. Melissa Berlin of Gloversville, a volunteer with the American Heart Association, is one of the hundreds of parents that helped push for the legislation. We were discharged from the hospital with a healthy baby boy. Yet, at his well-baby visit one week later, Colton began to turn blue. We were rushed to the emergency room, where we learned that he had a congenital heart defect, said Berlin. He has already had two out of three scheduled open heart surgeries.

Pulse ox | definition of pulse ox by Medical dictionary pulse ox
pulse ox
pulse ox
pulse ox
Pulse Oximetry
Common use
Area of application
Contrast
Description
This procedure is contraindicated for
Indications
Potential diagnosis
Normal findings
Abnormal findings related to
Critical findings
Interfering factors
>Factors that may result in incorrect values
Other considerations
Nursing Implications and Procedure
Pretest
Intratest
Post-Test
Related Monographs
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?
 Garmin's Connect website implied that if the watch owner opted in to typical Garmin Connect features, information such as heartbeat, pulse ox and similar data may be submitted to Garmin where it is stored and presumably available for analytics within the company. GARMIN AND YOUR PRIVACY
Another change was telling patients to keep their hands off their eyes for the first few postop hours, and placing the pulse ox on the nondominant hand. Tegaderm eliminates corneal abrasions in robotic surgery
The pulse oximetry test ( pulse ox) is used to measure the concentration of oxygen in the blood. What to expect when you're expecting a newborn screening panel
Pulse Ox- Pulse Ox activity tracker and a redesign of its companion app, Health Mate. Withings launches its connected health devices in India
Her Temperature was 36.8 degrees centigrade, pulse was 72 beats per minute, respiratory rate was 16, Blood pressure 131/73 and pulse ox was 98% on room air. Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin
Her H & H were very low; pulse ox 91%m and she had a personal history of splenic rupture when her bipolar son stopped his meds because he was feeling better. Life is a journey
The i2DTX platform includes a CardioSleeve and connected devices including an otoscope, pulse ox, IR thermometer and blood pressure cuff. Rijuven Launches Smart ECG Stethoscope Attachment for Pediatrics
"As a mum with a child who has a heart condition, I feel I need to do something to raise awareness and as a heart community we are trying to get this pulse ox made law. Have a heart for children like Ava
J., Missouri resident and inventor recently contracted invention assistance leader NewProductHelp.com to represent her Crazy Pulse Ox Adapters invention to industry over the next 2 years.

Pulse ox | definition of pulse ox by Medical dictionary

pulse ox
pulse ox
pulse ox
pulse ox
Pulse Oximetry
Common use
Area of application
Contrast
Description
This procedure is contraindicated for
Indications
Potential diagnosis
Normal findings
Abnormal findings related to
Critical findings
Interfering factors
>Factors that may result in incorrect values
Other considerations
Nursing Implications and Procedure
Pretest
Intratest
Post-Test
Related Monographs
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?

 Users of this Toolkit should not substitute information contained for professional judgment, nor should they rely solely on the information provided when rendering a diagnosis or choosing a course of medical treatment. Before undertaking implementation of any of the tactics discussed herein, users are advised to seek professional counsel on the issues raised by consulting with medical staff and senior managers for matters involving clinical practice and direct patient care. C. Intellectual Property
Children’s National Medical Center and any of its subsidiaries/programs, www.childrensnational.org, the Children’s National Medical Center logo, and all other text and images contained within this document are protected by the United States trademark and copyright laws. All are considered to be property of Children’s National Medical Center, except as otherwise identified. All rights are reserved. Materials included in this Toolkit may not be modified, reproduced, or displayed for any commercial or public purpose without specific written permission from Children’s National Medical Center. Any copyrights and trademarks that are not the property of Children’s National Medical Center, which may also be referenced in this document, remain the property of their respective owners. D. Liability
Children’s National Medical Center does not warrant the content of this document and specifically disclaims, to the fullest extent permitted by law, any and all warranties, express or implied, of any kind or nature whatsoever. Neither Children’s National Medical Center nor any of its subsidiaries/programs shall be liable under any circumstances for any claims, losses, or causes of action that may arise from the use of this Toolkit or the information contained in it. User Agreement
Program Overview
Vision Pulse Oximetry Screening for Congenital Heart Disease:

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
What is pulse oximetry?
Fetal ultrasounds of the heart do not detect all types of heart defects.
How is this screening is done?
What happens a baby fails the pulse oximetry screening?
If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?
Even if a baby passes the pulse oximetry screening, parents should watch:
Additional Information & Resources:
 Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org

In This Section
Healthy Children > Ages & Stages > Baby > Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
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Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
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Most babies are born with healthy hearts and have enough oxygen in their blood. However, about 1 baby in every 100 is born with a congenital heart defect (CHD) and 25% of those babies with CHD will have a critical congenital heart defect (CCHD). Babies with critical CHDs have low oxygen levels and usually require surgery or other procedures in the first year of life. Sometimes intervention must be done urgently, within the first days or weeks of a baby's life. Some examples of critical CHDs include coarctation of the aorta, transposition of the great arteries, hypoplastic left heart syndrome, and tetralogy of Fallot. What is pulse oximetry? Pulse oximetry ( also called pulse ox ) is a simple and painless test that measures the level oxygen is in the blood. There are types of CCHD that cause lower than usual blood oxygen levels and those can be picked up by pulse oximetry―even before a baby becomes sick. Early detection and appropriate management can then be provided and may improve a baby's outcome. The American Academy of Pediatrics (AAP) recommends pulse oximetry be performed at all newborn screenings to detect CCHD.

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
What is pulse oximetry?
Fetal ultrasounds of the heart do not detect all types of heart defects.
How is this screening is done?
What happens a baby fails the pulse oximetry screening?
If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?
Even if a baby passes the pulse oximetry screening, parents should watch:
Additional Information & Resources:

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org

In This Section
Healthy Children > Ages & Stages > Baby > Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Ages & Stages
Listen
Español
Text Size
- +
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Page Content
Most babies are born with healthy hearts and have enough oxygen in their blood. However, about 1 baby in every 100 is born with a congenital heart defect (CHD) and 25% of those babies with CHD will have a critical congenital heart defect (CCHD). Babies with critical CHDs have low oxygen levels and usually require surgery or other procedures in the first year of life. Sometimes intervention must be done urgently, within the first days or weeks of a baby's life. Some examples of critical CHDs include coarctation of the aorta, transposition of the great arteries, hypoplastic left heart syndrome, and tetralogy of Fallot. What is pulse oximetry? Pulse oximetry ( also called pulse ox ) is a simple and painless test that measures the level oxygen is in the blood. There are types of CCHD that cause lower than usual blood oxygen levels and those can be picked up by pulse oximetry―even before a baby becomes sick. Early detection and appropriate management can then be provided and may improve a baby's outcome. The American Academy of Pediatrics (AAP) recommends pulse oximetry be performed at all newborn screenings to detect CCHD.

 The Maryland law will not be implemented until there are federal recommendations for such screening. Other states are currently considering such legislation. BACKGROUND
The following information is from the Children's National Medical Center in Washington, D.C.
What is Congenital Heart Disease? CHD is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born in the United States each year have a form of CHD, some of which cause no or very few problems in the health and development of the child. But critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. What is Pulse Oximetry and How is it Performed?

The Maryland law will not be implemented until there are federal recommendations for such screening. Other states are currently considering such legislation. BACKGROUND
The following information is from the Children's National Medical Center in Washington, D.C.
What is Congenital Heart Disease? CHD is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born in the United States each year have a form of CHD, some of which cause no or very few problems in the health and development of the child. But critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. What is Pulse Oximetry and How is it Performed?

 Materials included in this Toolkit may not be modified, reproduced, or displayed for any commercial or public purpose without specific written permission from Children’s National Medical Center. Any copyrights and trademarks that are not the property of Children’s National Medical Center, which may also be referenced in this document, remain the property of their respective owners. D. Liability
Children’s National Medical Center does not warrant the content of this document and specifically disclaims, to the fullest extent permitted by law, any and all warranties, express or implied, of any kind or nature whatsoever. Neither Children’s National Medical Center nor any of its subsidiaries/programs shall be liable under any circumstances for any claims, losses, or causes of action that may arise from the use of this Toolkit or the information contained in it. User Agreement
Program Overview
Vision Pulse Oximetry Screening for Congenital Heart Disease: Who, What, When, Where, and Why? Opening Letter Screening Recommendations Letter to Providers Supplies for Screening Screening Form
Section 1Program Overview
CongHrt_Cover&Tabs9x11  10/11/11  12:56 PM  Page 3
Charles I. Berul, MD
Chief, Division of Cardiology Children's National Medical Center
This toolkit is an outstanding product that is the end result of much consideration and research, and will provide a straightforward, easy-to-use method to screen for cyanotic and serious forms of congenital heart disease in newborns. This program allows for a reliable, low-cost, high-throughput early detection program in the nursery setting, reducing the risks of complications from delayed diagnosis. I applaud the organizers and coordinators and hope that newborn pulse oximetry screening will quickly become widely implemented as standard of care. Through our expereince with research and helping hospitals to start CCHD screening programs in their nurseries we have learned a lot about best-practice for implementation.

 Mona Barmash, Children’s Heart Information Network • Holy Cross Hospital
CongHrt_Cover&Tabs9x11  10/11/11  12:56 PM  Page 2
User Agreement
♥Section 1 – Program Overview
Vision Pulse Oximetry Screening for Congenital Heart Disease: Who, What, When, Where, and Why? Opening Letter Screening Recommendations Letter to Providers Supplies for Screening Screening Form ♥Section 2 – Screener Training
In-Service Education Program Components Congenital Heart Disease Screening Program: Education for Providers Performing Pulse Oximetry with the Infant Patient: Education for Providers Pulse Ox Probe Placement Education Knowledge Assessment and Answer Key Competency Check List Training Log CHDSP PowerPoint Presentation Information ♥Section 3 – Education for Parents and Guardians
Checklist for Informing Mothers Frequently Asked Questions (FAQs) for Patients and Families Frequently Asked Questions (FAQs) for Patients and Families (Spanish) Congenital Heart Disease Screening Program: For Patients and Families Congenital Heart Disease Screening Program: For Patients and Families (Spanish) CHD Resources CHD Resources (Spanish) ♥Section 4 – Advocacy
♥Section 5 – References and Resource Lists
Table of Contents
Children’s National Medical Center’s Congenital Heart Disease Screening Program
Congenital Heart Disease Screening Program♥
4
A. Terms and Conditions
Please read this agreement in its entirety prior to use. The Congenital Heart Disease Screening Program Toolkit (“Toolkit”) is designed to serve as a guide to healthcare providers seeking to use pulse oximetry as a screening tool for critical congenital heart disease in the newborn nursery. By utilizing this Toolkit, you agree to the terms and conditions that follow. B. Disclaimer
Recommendations provided by Children’s National Medical Center are derived from a review of evidence- based literature on pulse oximetry screening for critical congenital heart disease and outcomes of the clinical research study titled “Feasibility of Implementation of Pulse Oximetry as a Screening Tool for Critical Congenital Heart Disease in the Newborn Nursery.”

Pulse Oximetry Pulse Oximetry
Pulse Oximetry
Contact Us
 A routine physical examination, as performed during the first 24 hours of life in most institutions, is only 50 percent effective in detecting CHD. The pulse-oximetry test can help identify infants with low levels of oxygen in their blood and may help diagnose critical CHD before an infant becomes sick. The test has been recommended as a screening test for critical CHD by the: U.S. Department of Health and Human Services
American Heart Association
American Academy of Pediatrics
American College of Cardiology
It is important to note, however, that it is possible for a baby with CHD to have a normal pulse-oximetry reading. CHD cannot be completely ruled out by a normal pulse-oximetry reading. Who Should Be Screened? All infants should be screened. When Should Screening Be Performed? Pulse-oximetry screening should be performed after the infant turns 24 hours of age and before discharge from the nursery. If the infant was born prematurely, screening should be performed when medically appropriate to do so.

Pulse Oximetry

A routine physical examination, as performed during the first 24 hours of life in most institutions, is only 50 percent effective in detecting CHD. The pulse-oximetry test can help identify infants with low levels of oxygen in their blood and may help diagnose critical CHD before an infant becomes sick. The test has been recommended as a screening test for critical CHD by the: U.S. Department of Health and Human Services
American Heart Association
American Academy of Pediatrics
American College of Cardiology
It is important to note, however, that it is possible for a baby with CHD to have a normal pulse-oximetry reading. CHD cannot be completely ruled out by a normal pulse-oximetry reading. Who Should Be Screened? All infants should be screened. When Should Screening Be Performed? Pulse-oximetry screening should be performed after the infant turns 24 hours of age and before discharge from the nursery. If the infant was born prematurely, screening should be performed when medically appropriate to do so.

Screening Newborns for Critical Congenital Heart Disease Screening Newborns for Critical Congenital Heart Disease
Screening Newborns for Critical Congenital Heart Disease It is not intended to replace taking a complete family health and pregnancy history, and completing a physical examination of the newborn, which sometimes can detect CCHDs before the development of hypoxemia or can detect children whose CCHDs are missed by pulse oximetry. Realize that pulse oximetry screening does not detect all CCHDs, even all of the 7 main screening targets. A "passed" screen does not rule out the possibility of a CCHD or other heart defect in your patient. For every 3 children detected with a CCHD by screening, 1 child with a CCHD will still be missed. Continued vigilance is necessary to recognize congenital heart defects if signs or symptoms, such as tachypnea, cyanosis, weak pulses, failure to thrive, extreme sleepiness, or a heart murmur, occur. Thank you for taking the time to learn more about screening for CCHDs. Please visit http://www.cdc.gov/ncbddd/pediatricgenetics/pulse.html for more information on this topic. Web Resources
Algorithm for CCHD screening from Children's Healthcare of Atlanta
CDC: Screening for Critical Congenital Heart Defects -- Information for Providers
CDC: Screening for Critical Congenital Heart Defects -- Information for Parents
Dr. Matt Oster is a pediatric cardiologist at Sibley Heart Center Cardiology in the Division of Pediatric Cardiology at Children's Healthcare of Atlanta.

Screening Newborns for Critical Congenital Heart Disease

Screening Newborns for Critical Congenital Heart Disease
Screening Newborns for Critical Congenital Heart Disease

It is not intended to replace taking a complete family health and pregnancy history, and completing a physical examination of the newborn, which sometimes can detect CCHDs before the development of hypoxemia or can detect children whose CCHDs are missed by pulse oximetry. Realize that pulse oximetry screening does not detect all CCHDs, even all of the 7 main screening targets. A "passed" screen does not rule out the possibility of a CCHD or other heart defect in your patient. For every 3 children detected with a CCHD by screening, 1 child with a CCHD will still be missed. Continued vigilance is necessary to recognize congenital heart defects if signs or symptoms, such as tachypnea, cyanosis, weak pulses, failure to thrive, extreme sleepiness, or a heart murmur, occur. Thank you for taking the time to learn more about screening for CCHDs. Please visit http://www.cdc.gov/ncbddd/pediatricgenetics/pulse.html for more information on this topic. Web Resources
Algorithm for CCHD screening from Children's Healthcare of Atlanta
CDC: Screening for Critical Congenital Heart Defects -- Information for Providers
CDC: Screening for Critical Congenital Heart Defects -- Information for Parents
Dr. Matt Oster is a pediatric cardiologist at Sibley Heart Center Cardiology in the Division of Pediatric Cardiology at Children's Healthcare of Atlanta.

Congenital Heart Defects Information for Healthcare Providers | CDC Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources
 Read article
pdf icon
[524 KB / 46 pages] ]
Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, Gidding SS, Beekman RH, 3rd, Grosse, SD. Role of pulse oximetry in examining newborns for congenital heart disease: A scientific statement from the AHA and AAP. Pediatrics. 2009;124:823-36. [ Read article
external icon
]
NewSTEPS
external icon
This webpage on critical congenital heart defects provides a central location for resources related to these conditions, including webinars, legislative updates, and news. NIH/NLM Newborn Screening Coding and Terminology Guide
external icon
This guide provides the data standards for electronic reporting of critical congenital heart defects. Pulse Ox Tool
external icon
This web application and mobile app are provided as a free service by Children’s Healthcare of Atlanta to aid healthcare professionals in screening for critical congenital heart defects. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies:

Congenital Heart Defects Information for Healthcare Providers | CDC

Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources

Read article
pdf icon
[524 KB / 46 pages] ]
Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, Gidding SS, Beekman RH, 3rd, Grosse, SD. Role of pulse oximetry in examining newborns for congenital heart disease: A scientific statement from the AHA and AAP. Pediatrics. 2009;124:823-36. [ Read article
external icon
]
NewSTEPS
external icon
This webpage on critical congenital heart defects provides a central location for resources related to these conditions, including webinars, legislative updates, and news. NIH/NLM Newborn Screening Coding and Terminology Guide
external icon
This guide provides the data standards for electronic reporting of critical congenital heart defects. Pulse Ox Tool
external icon
This web application and mobile app are provided as a free service by Children’s Healthcare of Atlanta to aid healthcare professionals in screening for critical congenital heart defects. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies:

 Some forms of CHD cause no or very few problems in the health, growth, and development of the infant. However, critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Pulse oximetry, or “pulse ox,” is a simple, non-invasive and painless test that is used to measure the percent oxygen saturation of hemoglobin in the arterial blood and the pulse rate. Pulse ox was invented in the 1970s and is now widely used and accepted in clinical care; it is often thought to be a basic vital sign. Why
is pulse ox used to screen for CHD? Pulse ox can help to identify infants with critical CHD that may have low levels of oxygen in their blood. Pulse ox screening may help diagnose critical CHD before an infant becomes sick.

Some forms of CHD cause no or very few problems in the health, growth, and development of the infant. However, critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Pulse oximetry, or “pulse ox,” is a simple, non-invasive and painless test that is used to measure the percent oxygen saturation of hemoglobin in the arterial blood and the pulse rate. Pulse ox was invented in the 1970s and is now widely used and accepted in clinical care; it is often thought to be a basic vital sign. Why
is pulse ox used to screen for CHD? Pulse ox can help to identify infants with critical CHD that may have low levels of oxygen in their blood. Pulse ox screening may help diagnose critical CHD before an infant becomes sick.

Dried Blood Spot and CCHD Newborn Screening | Idaho Department of Health and Welfare Dried Blood Spot and CCHD Newborn Screening
Dried Blood Spot and CCHD Newborn Screening
Dried blood spot newborn screening
For infants born “out of hospital”
Residual Bloodspot Specimen Request Form
FAQs
By the Numbers
Critical congenital heart disease (CCHD) screening
Contact Us
Idaho Newborn Screening Program
Phone
 These problems range from mild to severe. CCHD is often treatable, if caught early. Screening must be done when the baby is at least 24 hours of age, or as late as possible if the baby will be discharged from the hospital before 24 hours of age. Healthcare professionals check for CCHD by using pulse oximetry (or "pulse ox"). Pulse oximetry is a painless, noninvasive test that measures the amount of oxygen in your baby's blood. Hide lower priority columns

CCHD brochure in English
Contact Us
Idaho Newborn Screening Program
Phone
208-334-5962

Dried Blood Spot and CCHD Newborn Screening | Idaho Department of Health and Welfare

Dried Blood Spot and CCHD Newborn Screening
Dried Blood Spot and CCHD Newborn Screening
Dried blood spot newborn screening
For infants born “out of hospital”
Residual Bloodspot Specimen Request Form
FAQs
By the Numbers
Critical congenital heart disease (CCHD) screening
Contact Us
Idaho Newborn Screening Program
Phone

These problems range from mild to severe. CCHD is often treatable, if caught early. Screening must be done when the baby is at least 24 hours of age, or as late as possible if the baby will be discharged from the hospital before 24 hours of age. Healthcare professionals check for CCHD by using pulse oximetry (or "pulse ox"). Pulse oximetry is a painless, noninvasive test that measures the amount of oxygen in your baby's blood. Hide lower priority columns

CCHD brochure in English
Contact Us
Idaho Newborn Screening Program
Phone
208-334-5962

 For Patients and Families Congenital Heart Disease Screening Program: For Patients and Families (Spanish) CHD Resources CHD Resources (Spanish) ♥Section 4 – Advocacy
♥Section 5 – References and Resource Lists
Table of Contents
Children’s National Medical Center’s Congenital Heart Disease Screening Program
Congenital Heart Disease Screening Program♥
4
A. Terms and Conditions
Please read this agreement in its entirety prior to use. The Congenital Heart Disease Screening Program Toolkit (“Toolkit”) is designed to serve as a guide to healthcare providers seeking to use pulse oximetry as a screening tool for critical congenital heart disease in the newborn nursery. By utilizing this Toolkit, you agree to the terms and conditions that follow. B. Disclaimer
Recommendations provided by Children’s National Medical Center are derived from a review of evidence- based literature on pulse oximetry screening for critical congenital heart disease and outcomes of the clinical research study titled “Feasibility of Implementation of Pulse Oximetry as a Screening Tool for Critical Congenital Heart Disease in the Newborn Nursery.” Institutional Review Board approval was sought and obtained in this study. The information included in this Toolkit is for informational and educational purposes only. Children’s National Medical Center makes reasonable efforts to ensure that the information provided is complete, and where appropriate, based on scientific evidence; however, Children’s National Medical Center makes no assurances as to whether the provided information will at all times be current. Furthermore, this document does not reflect the best medical practice for all circumstances.

For Patients and Families Congenital Heart Disease Screening Program: For Patients and Families (Spanish) CHD Resources CHD Resources (Spanish) ♥Section 4 – Advocacy
♥Section 5 – References and Resource Lists
Table of Contents
Children’s National Medical Center’s Congenital Heart Disease Screening Program
Congenital Heart Disease Screening Program♥
4
A. Terms and Conditions
Please read this agreement in its entirety prior to use. The Congenital Heart Disease Screening Program Toolkit (“Toolkit”) is designed to serve as a guide to healthcare providers seeking to use pulse oximetry as a screening tool for critical congenital heart disease in the newborn nursery. By utilizing this Toolkit, you agree to the terms and conditions that follow. B. Disclaimer
Recommendations provided by Children’s National Medical Center are derived from a review of evidence- based literature on pulse oximetry screening for critical congenital heart disease and outcomes of the clinical research study titled “Feasibility of Implementation of Pulse Oximetry as a Screening Tool for Critical Congenital Heart Disease in the Newborn Nursery.” Institutional Review Board approval was sought and obtained in this study. The information included in this Toolkit is for informational and educational purposes only. Children’s National Medical Center makes reasonable efforts to ensure that the information provided is complete, and where appropriate, based on scientific evidence; however, Children’s National Medical Center makes no assurances as to whether the provided information will at all times be current. Furthermore, this document does not reflect the best medical practice for all circumstances.

Pulse ox | definition of pulse ox by Medical dictionary pulse ox
pulse ox
pulse ox
pulse ox
Pulse Oximetry
Common use
Area of application
Contrast
Description
This procedure is contraindicated for
Indications
Potential diagnosis
Normal findings
Abnormal findings related to
Critical findings
Interfering factors
>Factors that may result in incorrect values
Other considerations
Nursing Implications and Procedure
Pretest
Intratest
Post-Test
Related Monographs
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?
 Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin
Her H & H were very low; pulse ox 91%m and she had a personal history of splenic rupture when her bipolar son stopped his meds because he was feeling better. Life is a journey
The i2DTX platform includes a CardioSleeve and connected devices including an otoscope, pulse ox, IR thermometer and blood pressure cuff. Rijuven Launches Smart ECG Stethoscope Attachment for Pediatrics
"As a mum with a child who has a heart condition, I feel I need to do something to raise awareness and as a heart community we are trying to get this pulse ox made law. Have a heart for children like Ava
J., Missouri resident and inventor recently contracted invention assistance leader NewProductHelp.com to represent her Crazy Pulse Ox Adapters invention to industry over the next 2 years. NewProductHelp.com Tabbed to Represent Crazy Pulse Ox Adapters Invention to Potential Lic

Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin
Her H & H were very low; pulse ox 91%m and she had a personal history of splenic rupture when her bipolar son stopped his meds because he was feeling better. Life is a journey
The i2DTX platform includes a CardioSleeve and connected devices including an otoscope, pulse ox, IR thermometer and blood pressure cuff. Rijuven Launches Smart ECG Stethoscope Attachment for Pediatrics
"As a mum with a child who has a heart condition, I feel I need to do something to raise awareness and as a heart community we are trying to get this pulse ox made law. Have a heart for children like Ava
J., Missouri resident and inventor recently contracted invention assistance leader NewProductHelp.com to represent her Crazy Pulse Ox Adapters invention to industry over the next 2 years. NewProductHelp.com Tabbed to Represent Crazy Pulse Ox Adapters Invention to Potential Lic

 Nursing time required to do pulse oximetry testing on newborns averages about three minutes per baby. Some critics of mandatory pulse oximetry screening raise the issue of the added cost of echocardiography in false-positive cases. FEDERAL RECOMMENDATIONS
Requiring pulse oximetry screening for newborns has been a state level issue for several years with proposals to have it included with other mandatory screenings for newborns. In October 2010, the Department HHS Advisory Committee on Heritable Diseases in Newborns and Children made a recommendation to add CHD to the uniform screening panel. It stated that “although there are recognizable evidence gaps, there are compelling reasons for recommending newborns for CHD.” HHS Secretary Kathleen Sebelius had 180 days to either adopt or reject this recommendation. In April 2011, she responded in a letter to the Advisory Committee's chairperson acknowledging the “recognizable evidence gaps” and stated: “After consultation with HHS agency leadership, I have determined that the Advisory Committee's recommendations are not ready for adoption. However, because this is such an important issue, I am referring these recommendations to the newly established Interagency Coordinating Committee on Newborn and Child Screening (ICC) for additional review and input regarding implementation.” (The secretary's complete correspondence can be read at:

Nursing time required to do pulse oximetry testing on newborns averages about three minutes per baby. Some critics of mandatory pulse oximetry screening raise the issue of the added cost of echocardiography in false-positive cases. FEDERAL RECOMMENDATIONS
Requiring pulse oximetry screening for newborns has been a state level issue for several years with proposals to have it included with other mandatory screenings for newborns. In October 2010, the Department HHS Advisory Committee on Heritable Diseases in Newborns and Children made a recommendation to add CHD to the uniform screening panel. It stated that “although there are recognizable evidence gaps, there are compelling reasons for recommending newborns for CHD.” HHS Secretary Kathleen Sebelius had 180 days to either adopt or reject this recommendation. In April 2011, she responded in a letter to the Advisory Committee's chairperson acknowledging the “recognizable evidence gaps” and stated: “After consultation with HHS agency leadership, I have determined that the Advisory Committee's recommendations are not ready for adoption. However, because this is such an important issue, I am referring these recommendations to the newly established Interagency Coordinating Committee on Newborn and Child Screening (ICC) for additional review and input regarding implementation.” (The secretary's complete correspondence can be read at:

Congenital Heart Defects Information for Healthcare Providers | CDC Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources
 Passed Screens
Any screening with an oxygen saturation measure that is ≥95% in the right hand or foot with a ≤3% absolute difference between the right hand or foot is considered a passed screen and screening would end. Pulse oximetry screening does not detect all critical CHDs, so it is possible for a baby with a passing screening result to still have a critical CHD or other CHD. Ways to Reduce False Positive Screens
Screen the newborn while he or she is alert. Screen the newborn when he or she is at least 24 hours old. Other Tools or Resources
American Academy of Pediatrics: Critical Congenital Heart Defect (CCHD) Screening Resource for Primary Care Providers
external icon
This online resource was developed by doctors for doctors, to help primary care providers navigate the implementation process and provide effective, long-term medical homes for babies with critical CHDs. American Academy of Pediatrics: Endorsement of Health and Human Services Recommendation for Pulse Oximetry Screening for Critical Congenital Heart Disease [ Read article
pdf icon
[653 KB / 5 pages] ]
Children’s National Medical Center’s Congenital Heart Disease Screening Program has created videos
external icon
about critical CHD screening for parents and healthcare professionals. Congenital Heart Public Health Consortium
external icon
(CHPHC) The CHPHC is a group of organizations uniting resources and efforts in public health activities to prevent congenital heart defects and improve outcomes for affected children and adults. Their website provides resources for families and providers on heart defects and screening.

Passed Screens
Any screening with an oxygen saturation measure that is ≥95% in the right hand or foot with a ≤3% absolute difference between the right hand or foot is considered a passed screen and screening would end. Pulse oximetry screening does not detect all critical CHDs, so it is possible for a baby with a passing screening result to still have a critical CHD or other CHD. Ways to Reduce False Positive Screens
Screen the newborn while he or she is alert. Screen the newborn when he or she is at least 24 hours old. Other Tools or Resources
American Academy of Pediatrics: Critical Congenital Heart Defect (CCHD) Screening Resource for Primary Care Providers
external icon
This online resource was developed by doctors for doctors, to help primary care providers navigate the implementation process and provide effective, long-term medical homes for babies with critical CHDs. American Academy of Pediatrics: Endorsement of Health and Human Services Recommendation for Pulse Oximetry Screening for Critical Congenital Heart Disease [ Read article
pdf icon
[653 KB / 5 pages] ]
Children’s National Medical Center’s Congenital Heart Disease Screening Program has created videos
external icon
about critical CHD screening for parents and healthcare professionals. Congenital Heart Public Health Consortium
external icon
(CHPHC) The CHPHC is a group of organizations uniting resources and efforts in public health activities to prevent congenital heart defects and improve outcomes for affected children and adults. Their website provides resources for families and providers on heart defects and screening.

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
What is pulse oximetry?
Fetal ultrasounds of the heart do not detect all types of heart defects.
How is this screening is done?
What happens a baby fails the pulse oximetry screening?
If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?
Even if a baby passes the pulse oximetry screening, parents should watch:
Additional Information & Resources:
 If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects? Unfortunately, no. Pulse oximetry testing picks up only some types of CHD. Heart defects which are not causing a low blood oxygen level at the time of the screen are not picked up by the test. Even if a baby passes the pulse oximetry screening, parents should watch: How well their baby is feeding
Any difficulty in breathing
Increased irritability
Excessive sleepiness
Bluish color to the lips or skin
Grunting
Fast breathing
Poor weight gain
Parents are advised to contact their baby's doctor right away if they notice any of these signs. Additional Information & Resources: Newborn Screening Tests
Tests & Screenings During Pregnancy
Challenges Faced by Parents of Children with Congenital Heart Disease
Genetics and Congenital Heart Defects
Endorsement of Health and Human Services Recommendation for Pulse Oximetry Screening for Critical Congenital Heart Disease (AAP Policy Statement)
Association of U.S. State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease with Early Infant Cardiac Deaths (JAMA, 2017)

Article Body
Last Updated
2/11/2019
Source
AAP Section on Cardiology ＆ Cardiac Surgery (Copyright @ 2019 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects? Unfortunately, no. Pulse oximetry testing picks up only some types of CHD. Heart defects which are not causing a low blood oxygen level at the time of the screen are not picked up by the test. Even if a baby passes the pulse oximetry screening, parents should watch: How well their baby is feeding
Any difficulty in breathing
Increased irritability
Excessive sleepiness
Bluish color to the lips or skin
Grunting
Fast breathing
Poor weight gain
Parents are advised to contact their baby's doctor right away if they notice any of these signs. Additional Information & Resources: Newborn Screening Tests
Tests & Screenings During Pregnancy
Challenges Faced by Parents of Children with Congenital Heart Disease
Genetics and Congenital Heart Defects
Endorsement of Health and Human Services Recommendation for Pulse Oximetry Screening for Critical Congenital Heart Disease (AAP Policy Statement)
Association of U.S. State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease with Early Infant Cardiac Deaths (JAMA, 2017)

Article Body
Last Updated
2/11/2019
Source
AAP Section on Cardiology ＆ Cardiac Surgery (Copyright @ 2019 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

The probe does not puncture the skin and the measurement can usually be read in 30 to 60 seconds. Why is Pulse Oximetry Used to Screen for CHD? Pulse oximetry is used to measure how much oxygen is in the blood. It is a routinely used test that can be used to monitor a baby's oxygen level during a procedure or treatment and can also be helpful in determining if a baby's heart and lungs are healthy. Pulse oximetry can also help to identify babies with serious heart problems due to low levels of oxygen in their blood. A health care provider may ask for more testing (such as an ultrasound of the heart or an echocardiogram) when a low pulse oximetry reading is identified. Who Should be Screened and When Will the Test be Done? According to the Children's National Medical Center, all babies in the newborn nursery who are not already thought to have CHD should be screened. The pulse oximetry test should be performed when a baby is older than 24 hours. What is a Normal Reading?

The probe does not puncture the skin and the measurement can usually be read in 30 to 60 seconds. Why is Pulse Oximetry Used to Screen for CHD? Pulse oximetry is used to measure how much oxygen is in the blood. It is a routinely used test that can be used to monitor a baby's oxygen level during a procedure or treatment and can also be helpful in determining if a baby's heart and lungs are healthy. Pulse oximetry can also help to identify babies with serious heart problems due to low levels of oxygen in their blood. A health care provider may ask for more testing (such as an ultrasound of the heart or an echocardiogram) when a low pulse oximetry reading is identified. Who Should be Screened and When Will the Test be Done? According to the Children's National Medical Center, all babies in the newborn nursery who are not already thought to have CHD should be screened. The pulse oximetry test should be performed when a baby is older than 24 hours. What is a Normal Reading?

Pulse Oximetry Pulse Oximetry
Pulse Oximetry
Contact Us
 Pulse oximetry is a simple, non-invasive and painless test that is used to measure the percent of oxygen saturation of hemoglobin in the arterial blood and the pulse rate. The pulse-oximetry test was invented in the 1970s and is now widely used and accepted in clinical care. In fact, it is often considered a vital sign. Traditionally, pulse oximetry has been used to monitor an individual’s oxygen saturation during acute and chronic illness, as well as during procedures requiring general anesthesia or sedation. Why is Pulse Oximetry Used to Screen for CHD? A routine physical examination, as performed during the first 24 hours of life in most institutions, is only 50 percent effective in detecting CHD. The pulse-oximetry test can help identify infants with low levels of oxygen in their blood and may help diagnose critical CHD before an infant becomes sick. The test has been recommended as a screening test for critical CHD by the: U.S. Department of Health and Human Services
American Heart Association
American Academy of Pediatrics
American College of Cardiology
It is important to note, however, that it is possible for a baby with CHD to have a normal pulse-oximetry reading. CHD cannot be completely ruled out by a normal pulse-oximetry reading.

Pulse Oximetry

Pulse oximetry is a simple, non-invasive and painless test that is used to measure the percent of oxygen saturation of hemoglobin in the arterial blood and the pulse rate. The pulse-oximetry test was invented in the 1970s and is now widely used and accepted in clinical care. In fact, it is often considered a vital sign. Traditionally, pulse oximetry has been used to monitor an individual’s oxygen saturation during acute and chronic illness, as well as during procedures requiring general anesthesia or sedation. Why is Pulse Oximetry Used to Screen for CHD? A routine physical examination, as performed during the first 24 hours of life in most institutions, is only 50 percent effective in detecting CHD. The pulse-oximetry test can help identify infants with low levels of oxygen in their blood and may help diagnose critical CHD before an infant becomes sick. The test has been recommended as a screening test for critical CHD by the: U.S. Department of Health and Human Services
American Heart Association
American Academy of Pediatrics
American College of Cardiology
It is important to note, however, that it is possible for a baby with CHD to have a normal pulse-oximetry reading. CHD cannot be completely ruled out by a normal pulse-oximetry reading.

  Performing Pulse Oximetry (Pulse Ox) with the Infant Patient: EDUCATION FOR PROVIDERS
EDUCA
TION

FOR

PROVIDERS

Pulse

Ox

–

DOs

Pulse

Ox

–

DON’Ts

 Pulse

Ox

-

CAUTION! The

pulse

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needed

to

determine

the

oximetry

reading. Pulse

ox

is

not

accurate

if

the

patient

is

coding

or

is

having

a

cardiac

arrhythmia. Remember: No

pulse,

no

oximetry! Pulse

ox

readings

are

not

instantaneous. The

oximetry

reading

that

is

displayed

on

the

monitor

is

an

average

of

readings

over

the

past

few

seconds. childrenscolorado.org/CCHDScreening
p: 720-777-6820

Pulse

Ox

-

CAUTION! The

pulse

is

needed

to

determine

the

oximetry

reading. Pulse

ox

is

not

accurate

if

the

patient

is

coding

or

is

having

a

cardiac

arrhythmia. Remember: No

pulse,

no

oximetry! Pulse

ox

readings

are

not

instantaneous. The

oximetry

reading

that

is

displayed

on

the

monitor

is

an

average

of

readings

over

the

past

few

seconds. childrenscolorado.org/CCHDScreening
p: 720-777-6820

All babies deserve a healthy start with a healthy heart. Pulse oximetry screening, which tests the amount of oxygen in a newborns blood, can detect many CHDs and most types of CCHDs, which often are not identified through other screening methods for CHD, such as prenatal ultrasounds and routine newborn physical examinations. The screening is non-invasive and painless. It is conducted by attaching sensors to a babys hand and foot between 24 and 48 hours of his or her birth. If oxygen levels are too low, additional tests would then be conducted to detect any potential heart defects that may be present in the baby. Melissa Berlin of Gloversville, a volunteer with the American Heart Association, is one of the hundreds of parents that helped push for the legislation. We were discharged from the hospital with a healthy baby boy. Yet, at his well-baby visit one week later, Colton began to turn blue. We were rushed to the emergency room, where we learned that he had a congenital heart defect, said Berlin. He has already had two out of three scheduled open heart surgeries.

Minnesota | Baby's First Test | Newborn Screening | Baby Health Minnesota
States Minnesota
Conditions Screened
The Minnesota Program
Download Brochure
What Conditions are Screened For in Minnesota?
Amino Acid Disorders
Endocrine Disorders
Hemoglobin Disorders
Lysosomal Storage Disorders
About Newborn Screening in Minnesota
Program Overview:
Our Goals:
Blood Spot Screening
Hearing Screening
Pulse Oximetry Screening
How is Newborn Screening Paid for in Minnesota?
Policies and Resources
Support for families:
Storage and Use of Dried Blood Spots:
 To screen all Minnesota infants. To identify infants with rare, hidden disorders or with hearing loss at an early age when treatment and intervention can prevent health problems, help facilitate development, and save lives. To ensure that all infants with abnormal newborn screens have access to prompt diagnostic assessments and receive early intervention services. To improve systems for follow-up, reporting, and connection to services for infants identified by newborn screening. Newborn screening in Minnesota consists of three tests: blood spot screening, hearing screening, and pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. screening.

Minnesota | Baby's First Test | Newborn Screening | Baby Health

Minnesota
States Minnesota
Conditions Screened
The Minnesota Program
Download Brochure
What Conditions are Screened For in Minnesota?
Amino Acid Disorders
Endocrine Disorders
Hemoglobin Disorders
Lysosomal Storage Disorders
About Newborn Screening in Minnesota
Program Overview:
Our Goals:
Blood Spot Screening
Hearing Screening
Pulse Oximetry Screening
How is Newborn Screening Paid for in Minnesota?
Policies and Resources
Support for families:
Storage and Use of Dried Blood Spots:

To screen all Minnesota infants. To identify infants with rare, hidden disorders or with hearing loss at an early age when treatment and intervention can prevent health problems, help facilitate development, and save lives. To ensure that all infants with abnormal newborn screens have access to prompt diagnostic assessments and receive early intervention services. To improve systems for follow-up, reporting, and connection to services for infants identified by newborn screening. Newborn screening in Minnesota consists of three tests: blood spot screening, hearing screening, and pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. screening.

 http://www.hrsa.gov/heritabledisorderscommittee/correspondence/CCCHDSecResponse042011.pdf
The ICC includes the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration, Agency for Healthcare research and Quality, and the Food and Drug Administration. The ICC is examining the evidence gaps as described by the Advisory Committee and will propose a plan of action to address the identification of effective screening technologies, development of diagnostic processes and protocols, education of providers and the public, and strengthening infrastructure needs for follow-up and surveillance. AHA POLICY POSITION
The AHA issued a policy position statement on pulse oximetry screening of newborns in November 2010. It states: The AHA continues to advocate for effective, comprehensive screening for critical (requiring surgical or catheter intervention in the first year of life) congenital heart disease in newborns. Pulse oximetry testing before discharge may be one important strategy for such screening as it can be an effective, noninvasive, inexpensive tool to assist in diagnosing critical congenital heart disease. While the risk for use of this screening is minimal, and the benefits are still being fully elucidated, the AHA reaffirms its current recommendation supporting consideration of pulse oximetry as a screening methodology (Class IIA-Level of Evidence C)1based on consensus science versus extensive randomized controlled trials. RECENT UNITED KINGDOM STUDY
In one of the largest studies of its kind, United Kingdom researchers have demonstrated that pulse oximetry testing of newborns improves the detection of critical congenital heart disease, identifying defects that go undetected with antenatal ultrasound. The study, published in Lancet this month, involved the pulse oximetry screening, between February 2008 and January 2009, of 20,055 apparently healthy newborns from six maternity units across the United Kingdom. Of the total number of babies, 53 had major congenital heart disease (24 critical), a prevalence of 2.6 per 1000 live births.

Critical Congenital Heart Disease | Ohio Department of Health Critical Congenital Heart Disease
Critical Congenital Heart Disease
Facts about Congenital Heart Disease
CCHD Resources
Contact Us
 The test is done using a machine called a pulse oximeter, with sensors placed on the baby's right hand and one foot (either right or left). The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect CCHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Timing of CCHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CCHDs. These seven main screening targets are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as the main screening targets and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven disorders listed as the main screening targets. CCHD Resources
Centers for Disease Control & Prevention
http://www.cdc.gov/ncbddd/heartdefects/screening.html
Baby’s First Test
http://www.babysfirsttest.org/newborn-screening/conditions/critical-congenital-heart-disease-cchd
Federal Maternal & Child Health Bureau
http://www.newbornscreening.info/Parents/otherdisorders/CCHD.html
American Academy of Pediatrics
http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/PEHDIC/Pages/Newborn-Screening-for-CCHD.aspx
Contact Us
Naomi Halverson
Critical Congenital Heart Disease Newborn Screening
Ohio Department of Health
246 N. High St.
Columbus, Ohio 43215
Phone:

Critical Congenital Heart Disease | Ohio Department of Health

Critical Congenital Heart Disease
Critical Congenital Heart Disease
Facts about Congenital Heart Disease
CCHD Resources
Contact Us

 The Maryland law will not be implemented until there are federal recommendations for such screening. Other states are currently considering such legislation. BACKGROUND
The following information is from the Children's National Medical Center in Washington, D.C.
What is Congenital Heart Disease? CHD is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born in the United States each year have a form of CHD, some of which cause no or very few problems in the health and development of the child. But critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. What is Pulse Oximetry and How is it Performed?

The Maryland law will not be implemented until there are federal recommendations for such screening. Other states are currently considering such legislation. BACKGROUND
The following information is from the Children's National Medical Center in Washington, D.C.
What is Congenital Heart Disease? CHD is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born in the United States each year have a form of CHD, some of which cause no or very few problems in the health and development of the child. But critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. What is Pulse Oximetry and How is it Performed?

Masimo - CCHD Screening CCHD Screening with Pulse Oximetry
CCHD Screening with Pulse Oximetry
Critical Congenital Heart Disease
CCHD Screening with Pulse Oximetry
Why is it Important to use Masimo SET ® Pulse Oximetry for CCHD Screening?
Performance During Motion and Low Perfusion 12
Improved Critical Congenital Heart Disease Screening Sensitivity vs. Clinical Assessment Alone 5
How to Conduct CCHD Screening with Pulse Oximetry
Masimo Solutions for CCHD Screening with Pulse Oximetry
Learn More About CCHD Screening with Masimo SET ®
RESOURCES
CCHD Screening with Pulse Oximetry Solutions
CCHD Screening
Masimo SET
 2007 Oct;96 (10):1455-9. 14. Meberg A et al. Pediatr. 2008 Jun;152 (6):761-5. 15. Ewer AK et al. Lancet. 2011 Aug 27;378 (9793):785-94. RESOURCES
CCHD Screening with Pulse Oximetry Solutions
Brochure
CCHD Screening
Instructional Guide
Masimo SET
Product Information
View Clinical Evidence
Caution:

Masimo - CCHD Screening

CCHD Screening with Pulse Oximetry
CCHD Screening with Pulse Oximetry
Critical Congenital Heart Disease
CCHD Screening with Pulse Oximetry
Why is it Important to use Masimo SET ® Pulse Oximetry for CCHD Screening?
Performance During Motion and Low Perfusion 12
Improved Critical Congenital Heart Disease Screening Sensitivity vs. Clinical Assessment Alone 5
How to Conduct CCHD Screening with Pulse Oximetry
Masimo Solutions for CCHD Screening with Pulse Oximetry
Learn More About CCHD Screening with Masimo SET ®
RESOURCES
CCHD Screening with Pulse Oximetry Solutions
CCHD Screening
Masimo SET

2007 Oct;96 (10):1455-9. 14. Meberg A et al. Pediatr. 2008 Jun;152 (6):761-5. 15. Ewer AK et al. Lancet. 2011 Aug 27;378 (9793):785-94. RESOURCES
CCHD Screening with Pulse Oximetry Solutions
Brochure
CCHD Screening
Instructional Guide
Masimo SET
Product Information
View Clinical Evidence
Caution:

Screening Newborns for Critical Congenital Heart Disease Screening Newborns for Critical Congenital Heart Disease
Screening Newborns for Critical Congenital Heart Disease Without treatment, these babies are at risk for significant morbidity or mortality early in life as a result of closure of the ductus arteriosus or other physiologic changes. Screening for CCHDs is conducted with a pulse oximeter to measure the percentage of hemoglobin in the blood that is saturated with oxygen, with probes placed on the infant's right hand and either foot. An algorithm, either the algorithm recommended by the American Academy of Pediatrics or a similar one approved by the state or hospital, is then used to determine whether the infant passes, fails, or needs repeat pulse oximetry screening. Screening is performed when the infant is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse oximetry screening is most likely to detect 7 of the types of CCHDs. These 7 main screening targets are: Hypoplastic left heart syndrome; Pulmonary atresia (with intact septum); Tetralogy of Fallot; Total anomalous pulmonary venous return;

Without treatment, these babies are at risk for significant morbidity or mortality early in life as a result of closure of the ductus arteriosus or other physiologic changes. Screening for CCHDs is conducted with a pulse oximeter to measure the percentage of hemoglobin in the blood that is saturated with oxygen, with probes placed on the infant's right hand and either foot. An algorithm, either the algorithm recommended by the American Academy of Pediatrics or a similar one approved by the state or hospital, is then used to determine whether the infant passes, fails, or needs repeat pulse oximetry screening. Screening is performed when the infant is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse oximetry screening is most likely to detect 7 of the types of CCHDs. These 7 main screening targets are: Hypoplastic left heart syndrome; Pulmonary atresia (with intact septum); Tetralogy of Fallot; Total anomalous pulmonary venous return;

Screening Newborns for Critical Congenital Heart Disease Screening Newborns for Critical Congenital Heart Disease
Screening Newborns for Critical Congenital Heart Disease Critical congenital heart defects (CCHDs; also referred to as "critical congenital heart disease ") are the most recent addition to the United States Recommended Uniform Screening Panel for newborns. As more hospitals start screening newborns for CCHDs, you will need to understand what this screening means for your patients. CCHDs are structural heart defects that often are associated with hypoxemia in infants during the newborn period. Infants with CCHDs require surgery or catheter intervention within the first year of life, often soon after birth. Without treatment, these babies are at risk for significant morbidity or mortality early in life as a result of closure of the ductus arteriosus or other physiologic changes. Screening for CCHDs is conducted with a pulse oximeter to measure the percentage of hemoglobin in the blood that is saturated with oxygen, with probes placed on the infant's right hand and either foot. An algorithm, either the algorithm recommended by the American Academy of Pediatrics or a similar one approved by the state or hospital, is then used to determine whether the infant passes, fails, or needs repeat pulse oximetry screening. Screening is performed when the infant is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse oximetry screening is most likely to detect 7 of the types of CCHDs.

Critical congenital heart defects (CCHDs; also referred to as "critical congenital heart disease ") are the most recent addition to the United States Recommended Uniform Screening Panel for newborns. As more hospitals start screening newborns for CCHDs, you will need to understand what this screening means for your patients. CCHDs are structural heart defects that often are associated with hypoxemia in infants during the newborn period. Infants with CCHDs require surgery or catheter intervention within the first year of life, often soon after birth. Without treatment, these babies are at risk for significant morbidity or mortality early in life as a result of closure of the ductus arteriosus or other physiologic changes. Screening for CCHDs is conducted with a pulse oximeter to measure the percentage of hemoglobin in the blood that is saturated with oxygen, with probes placed on the infant's right hand and either foot. An algorithm, either the algorithm recommended by the American Academy of Pediatrics or a similar one approved by the state or hospital, is then used to determine whether the infant passes, fails, or needs repeat pulse oximetry screening. Screening is performed when the infant is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse oximetry screening is most likely to detect 7 of the types of CCHDs.

Screening Newborns for Critical Congenital Heart Disease Screening Newborns for Critical Congenital Heart Disease
Screening Newborns for Critical Congenital Heart Disease It is not intended to replace taking a complete family health and pregnancy history, and completing a physical examination of the newborn, which sometimes can detect CCHDs before the development of hypoxemia or can detect children whose CCHDs are missed by pulse oximetry. Realize that pulse oximetry screening does not detect all CCHDs, even all of the 7 main screening targets. A "passed" screen does not rule out the possibility of a CCHD or other heart defect in your patient. For every 3 children detected with a CCHD by screening, 1 child with a CCHD will still be missed. Continued vigilance is necessary to recognize congenital heart defects if signs or symptoms, such as tachypnea, cyanosis, weak pulses, failure to thrive, extreme sleepiness, or a heart murmur, occur. Thank you for taking the time to learn more about screening for CCHDs. Please visit http://www.cdc.gov/ncbddd/pediatricgenetics/pulse.html for more information on this topic. Web Resources
Algorithm for CCHD screening from Children's Healthcare of Atlanta
CDC: Screening for Critical Congenital Heart Defects -- Information for Providers
CDC: Screening for Critical Congenital Heart Defects -- Information for Parents
Dr. Matt Oster is a pediatric cardiologist at Sibley Heart Center Cardiology in the Division of Pediatric Cardiology at Children's Healthcare of Atlanta.

It is not intended to replace taking a complete family health and pregnancy history, and completing a physical examination of the newborn, which sometimes can detect CCHDs before the development of hypoxemia or can detect children whose CCHDs are missed by pulse oximetry. Realize that pulse oximetry screening does not detect all CCHDs, even all of the 7 main screening targets. A "passed" screen does not rule out the possibility of a CCHD or other heart defect in your patient. For every 3 children detected with a CCHD by screening, 1 child with a CCHD will still be missed. Continued vigilance is necessary to recognize congenital heart defects if signs or symptoms, such as tachypnea, cyanosis, weak pulses, failure to thrive, extreme sleepiness, or a heart murmur, occur. Thank you for taking the time to learn more about screening for CCHDs. Please visit http://www.cdc.gov/ncbddd/pediatricgenetics/pulse.html for more information on this topic. Web Resources
Algorithm for CCHD screening from Children's Healthcare of Atlanta
CDC: Screening for Critical Congenital Heart Defects -- Information for Providers
CDC: Screening for Critical Congenital Heart Defects -- Information for Parents
Dr. Matt Oster is a pediatric cardiologist at Sibley Heart Center Cardiology in the Division of Pediatric Cardiology at Children's Healthcare of Atlanta.

Congenital Heart Defects Information for Healthcare Providers | CDC Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources
 Read article
external icon
]
NewSTEPS
external icon
This webpage on critical congenital heart defects provides a central location for resources related to these conditions, including webinars, legislative updates, and news. NIH/NLM Newborn Screening Coding and Terminology Guide
external icon
This guide provides the data standards for electronic reporting of critical congenital heart defects. Pulse Ox Tool
external icon
This web application and mobile app are provided as a free service by Children’s Healthcare of Atlanta to aid healthcare professionals in screening for critical congenital heart defects. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet. 2012; 379:2459-64. [ Read article
external icon
]
Disclaimer:

Read article
external icon
]
NewSTEPS
external icon
This webpage on critical congenital heart defects provides a central location for resources related to these conditions, including webinars, legislative updates, and news. NIH/NLM Newborn Screening Coding and Terminology Guide
external icon
This guide provides the data standards for electronic reporting of critical congenital heart defects. Pulse Ox Tool
external icon
This web application and mobile app are provided as a free service by Children’s Healthcare of Atlanta to aid healthcare professionals in screening for critical congenital heart defects. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet. 2012; 379:2459-64. [ Read article
external icon
]
Disclaimer:

Ohio | Baby's First Test | Newborn Screening | Baby Health Ohio
States Ohio
Conditions Screened
The Ohio Program
Download Brochure
What Conditions are Screened For in Ohio?
Amino Acid Disorders
Endocrine Disorders
Fatty Acid Oxidation Disorders
Hemoglobin Disorders
Lysosomal Storage Disorders
Organic Acid Conditions
Other Disorders
About Newborn Screening in Ohio
Program Overview:
How is Newborn Screening Paid for in Ohio?
Policies and Resources
Support for families:
Storage and Use of Dried Blood Spots:
 A hearing screen to check to for hearing loss and a pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. screen to check for critical heart defects are usually done at the birth hospital the day after a baby is born. These screenings are non-invasive
A medical test or procedure that does not require a doctor to insert any device through the skin or into a body opening
and do not hurt the newborn. Parents are told the results of the hearing and heart screens after the testing is completed and the baby’s primary healthcare provider is also informed. If the baby is not born in a hospital, the midwife, doctor or local health department will help arrange the hearing and pulse oximetry screening. If the results for either the hearing screening or pulse oximetry screening are abnormal, the baby will be referred for additional testing. It is important that babies who need additional testing get the testing done right away.

Ohio | Baby's First Test | Newborn Screening | Baby Health

Ohio
States Ohio
Conditions Screened
The Ohio Program
Download Brochure
What Conditions are Screened For in Ohio?
Amino Acid Disorders
Endocrine Disorders
Fatty Acid Oxidation Disorders
Hemoglobin Disorders
Lysosomal Storage Disorders
Organic Acid Conditions
Other Disorders
About Newborn Screening in Ohio
Program Overview:
How is Newborn Screening Paid for in Ohio?
Policies and Resources
Support for families:
Storage and Use of Dried Blood Spots:

A hearing screen to check to for hearing loss and a pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. screen to check for critical heart defects are usually done at the birth hospital the day after a baby is born. These screenings are non-invasive
A medical test or procedure that does not require a doctor to insert any device through the skin or into a body opening
and do not hurt the newborn. Parents are told the results of the hearing and heart screens after the testing is completed and the baby’s primary healthcare provider is also informed. If the baby is not born in a hospital, the midwife, doctor or local health department will help arrange the hearing and pulse oximetry screening. If the results for either the hearing screening or pulse oximetry screening are abnormal, the baby will be referred for additional testing. It is important that babies who need additional testing get the testing done right away.

Dried Blood Spot and CCHD Newborn Screening | Idaho Department of Health and Welfare Dried Blood Spot and CCHD Newborn Screening
Dried Blood Spot and CCHD Newborn Screening
Dried blood spot newborn screening
For infants born “out of hospital”
Residual Bloodspot Specimen Request Form
FAQs
By the Numbers
Critical congenital heart disease (CCHD) screening
Contact Us
Idaho Newborn Screening Program
Phone
 These problems range from mild to severe. CCHD is often treatable, if caught early. Screening must be done when the baby is at least 24 hours of age, or as late as possible if the baby will be discharged from the hospital before 24 hours of age. Healthcare professionals check for CCHD by using pulse oximetry (or "pulse ox"). Pulse oximetry is a painless, noninvasive test that measures the amount of oxygen in your baby's blood. Hide lower priority columns

CCHD brochure in English
Contact Us
Idaho Newborn Screening Program
Phone
208-334-5962

These problems range from mild to severe. CCHD is often treatable, if caught early. Screening must be done when the baby is at least 24 hours of age, or as late as possible if the baby will be discharged from the hospital before 24 hours of age. Healthcare professionals check for CCHD by using pulse oximetry (or "pulse ox"). Pulse oximetry is a painless, noninvasive test that measures the amount of oxygen in your baby's blood. Hide lower priority columns

CCHD brochure in English
Contact Us
Idaho Newborn Screening Program
Phone
208-334-5962

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
What is pulse oximetry?
Fetal ultrasounds of the heart do not detect all types of heart defects.
How is this screening is done?
What happens a baby fails the pulse oximetry screening?
If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?
Even if a baby passes the pulse oximetry screening, parents should watch:
Additional Information & Resources:
 What is pulse oximetry? Pulse oximetry ( also called pulse ox ) is a simple and painless test that measures the level oxygen is in the blood. There are types of CCHD that cause lower than usual blood oxygen levels and those can be picked up by pulse oximetry―even before a baby becomes sick. Early detection and appropriate management can then be provided and may improve a baby's outcome. The American Academy of Pediatrics (AAP) recommends pulse oximetry be performed at all newborn screenings to detect CCHD. As of 2018, policies for screening newborns have been implemented in all states in the U.S.
Fetal ultrasounds of the heart do not detect all types of heart defects. While many problems in the fetal heart are now found early by fetal ultrasounds―and families are getting referred earlier to pediatric cardiologists for further care, there are still cases of CHD that can be missed. Many newborns develop signs and symptoms of CCHD such as turning very blue or breathing fast right after birth. Those babies are diagnosed and treated before being discharged from the hospital. However, there are babies with certain types of CCHD who may look and act healthy for several days before becoming suddenly seriously ill at home.

What is pulse oximetry? Pulse oximetry ( also called pulse ox ) is a simple and painless test that measures the level oxygen is in the blood. There are types of CCHD that cause lower than usual blood oxygen levels and those can be picked up by pulse oximetry―even before a baby becomes sick. Early detection and appropriate management can then be provided and may improve a baby's outcome. The American Academy of Pediatrics (AAP) recommends pulse oximetry be performed at all newborn screenings to detect CCHD. As of 2018, policies for screening newborns have been implemented in all states in the U.S.
Fetal ultrasounds of the heart do not detect all types of heart defects. While many problems in the fetal heart are now found early by fetal ultrasounds―and families are getting referred earlier to pediatric cardiologists for further care, there are still cases of CHD that can be missed. Many newborns develop signs and symptoms of CCHD such as turning very blue or breathing fast right after birth. Those babies are diagnosed and treated before being discharged from the hospital. However, there are babies with certain types of CCHD who may look and act healthy for several days before becoming suddenly seriously ill at home.

 HHS Secretary Kathleen Sebelius had 180 days to either adopt or reject this recommendation. In April 2011, she responded in a letter to the Advisory Committee's chairperson acknowledging the “recognizable evidence gaps” and stated: “After consultation with HHS agency leadership, I have determined that the Advisory Committee's recommendations are not ready for adoption. However, because this is such an important issue, I am referring these recommendations to the newly established Interagency Coordinating Committee on Newborn and Child Screening (ICC) for additional review and input regarding implementation.” (The secretary's complete correspondence can be read at: http://www.hrsa.gov/heritabledisorderscommittee/correspondence/CCCHDSecResponse042011.pdf
The ICC includes the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration, Agency for Healthcare research and Quality, and the Food and Drug Administration. The ICC is examining the evidence gaps as described by the Advisory Committee and will propose a plan of action to address the identification of effective screening technologies, development of diagnostic processes and protocols, education of providers and the public, and strengthening infrastructure needs for follow-up and surveillance. AHA POLICY POSITION
The AHA issued a policy position statement on pulse oximetry screening of newborns in November 2010. It states: The AHA continues to advocate for effective, comprehensive screening for critical (requiring surgical or catheter intervention in the first year of life) congenital heart disease in newborns.

HHS Secretary Kathleen Sebelius had 180 days to either adopt or reject this recommendation. In April 2011, she responded in a letter to the Advisory Committee's chairperson acknowledging the “recognizable evidence gaps” and stated: “After consultation with HHS agency leadership, I have determined that the Advisory Committee's recommendations are not ready for adoption. However, because this is such an important issue, I am referring these recommendations to the newly established Interagency Coordinating Committee on Newborn and Child Screening (ICC) for additional review and input regarding implementation.” (The secretary's complete correspondence can be read at: http://www.hrsa.gov/heritabledisorderscommittee/correspondence/CCCHDSecResponse042011.pdf
The ICC includes the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration, Agency for Healthcare research and Quality, and the Food and Drug Administration. The ICC is examining the evidence gaps as described by the Advisory Committee and will propose a plan of action to address the identification of effective screening technologies, development of diagnostic processes and protocols, education of providers and the public, and strengthening infrastructure needs for follow-up and surveillance. AHA POLICY POSITION
The AHA issued a policy position statement on pulse oximetry screening of newborns in November 2010. It states: The AHA continues to advocate for effective, comprehensive screening for critical (requiring surgical or catheter intervention in the first year of life) congenital heart disease in newborns.

 We hope that you find the contents in this toolkit helpful and we applaud you for raising the bar in your nurseries to improve the outcomes of patients and families with CCHD. Program Overview
Elizabeth A. Bradshaw, MSN, RN, CPN
Clinical Program Coordinator, Cardiac Research
CongHrt_Cover&Tabs9x11  10/27/11  12:32 PM  Page 4
Congenital Heart Disease Screening Program♥
7
Program Overview What
is congenital heart disease and pulse oximetry? Congenital heart disease (CHD) is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born have a form of CHD. Some forms of CHD cause no or very few problems in the health, growth, and development of the infant. However, critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Pulse oximetry, or “pulse ox,” is a simple, non-invasive and painless test that is used to measure the percent oxygen saturation of hemoglobin in the arterial blood and the pulse rate.

We hope that you find the contents in this toolkit helpful and we applaud you for raising the bar in your nurseries to improve the outcomes of patients and families with CCHD. Program Overview
Elizabeth A. Bradshaw, MSN, RN, CPN
Clinical Program Coordinator, Cardiac Research
CongHrt_Cover&Tabs9x11  10/27/11  12:32 PM  Page 4
Congenital Heart Disease Screening Program♥
7
Program Overview What
is congenital heart disease and pulse oximetry? Congenital heart disease (CHD) is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born have a form of CHD. Some forms of CHD cause no or very few problems in the health, growth, and development of the infant. However, critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Pulse oximetry, or “pulse ox,” is a simple, non-invasive and painless test that is used to measure the percent oxygen saturation of hemoglobin in the arterial blood and the pulse rate.

Critical congenital heart disease | Baby's First Test | Newborn Screening | Baby Health Critical Congenital Heart Disease
Conditions Critical Congenital Heart Disease
Condition Type
Frequency
Also known as
Follow-Up Testing
Heart Smart: CCHD Screening for Parents
About Critical Congenital Heart Disease
Support for Critical Congenital Heart Disease
References & Sources
ACT Sheets
 Follow-up testing confirms if a baby has a condition or not. take place. Because the harmful effects of CCHD can develop shortly after birth, follow-up testing must be completed as soon as possible to determine whether or not your baby has a heart problem. The baby’s doctor might recommend that the baby get screened with pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. again, will do a complete clinical assessment, or have more specific tests, like an echocardiogram (an ultrasound picture of the heart), an EKG (electrocardiogram), or a chest x-ray to diagnose CCHD. YouTube
Genetic Alliance
836 subscribers
Subscribe
Heart Smart: CCHD Screening for Parents
Watch later
Copy link
Info
Shopping
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Critical congenital heart disease | Baby's First Test | Newborn Screening | Baby Health

Critical Congenital Heart Disease
Conditions Critical Congenital Heart Disease
Condition Type
Frequency
Also known as
Follow-Up Testing
Heart Smart: CCHD Screening for Parents
About Critical Congenital Heart Disease
Support for Critical Congenital Heart Disease
References & Sources
ACT Sheets

Follow-up testing confirms if a baby has a condition or not. take place. Because the harmful effects of CCHD can develop shortly after birth, follow-up testing must be completed as soon as possible to determine whether or not your baby has a heart problem. The baby’s doctor might recommend that the baby get screened with pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. again, will do a complete clinical assessment, or have more specific tests, like an echocardiogram (an ultrasound picture of the heart), an EKG (electrocardiogram), or a chest x-ray to diagnose CCHD. YouTube
Genetic Alliance
836 subscribers
Subscribe
Heart Smart: CCHD Screening for Parents
Watch later
Copy link
Info
Shopping
Tap to unmute
If playback doesn't begin shortly, try restarting your device.

  PULSE OX PROBE PLACEMENT
PULSE

OX

PROBE

PLACEMENT

PULSE

OX

PROBE

PLACEMENT

EDUCATION

Pulse

oximetry

equipment

used

for

CCHD

Screening:

FDA

CLEARANCE

FOR

PULSE

OXIMETER

USE

IN

NEONATES

PERFORMING

PULSE

OX-

PULSE

OX

DO’s

PULSE

OX

DON’Ts

PULSE

OX

CAUTION

CRITICAL

CONGENITAL

HEART

DEFECTS:

Pulse

oximetry

screening

is

most

likely

to

detect

seven

of

the

CCHDs.

These

seven

main

screening

targets

are:

D-transposition

of

the

Great

Arteries

Tetralogy

of

Fallot

Total

anomalous

pulmonary

venous

return

(TAPVC)

Truncus

Arteriosus

Hypoplastic

Left

Heart

Syndrome

(HLHS)

Pulmonary

Atresia

Tricuspid

Atresia

These

defects

are

less

likely

to

be

detected

through

pulse

oximetry

screening:

Coarctation

of

the

Aorta

Ebstein

Anomaly

Double-outlet

right

Ventricle

Interrupted

aortic

arch

Single

ventricle

SUGGESTED

RESOURCES

FOR

PROVIDERS

Michigan

Department

of

Community

Health

Atlanta

Children’s

Hospital

*

American

Academy

of

Pediatrics

American

Heart

Association

Children’s

National

Medical

Center
-
Washington

DC
*

Children’s

Hospital

of

Philadelphia

(CHOP)*

Cincinnati

Children’s

Hospital

*

Center

for

Disease

Control

and

Prevention

Congenital

Heart

Information

Network*

Baby’s

First

Test
*

MICHIGAN

Treatment

Centers

for

CCHD:

Children’s

Hospital

of

Michigan
Helen

DeVos

Children’s

Hospital
3901

Beaubien
Congenital

Heart

Center

Congenital

Heart

Center

at

C.S.

Mott

Children’s

Hospital

 It

is

not

recommended

to

use

tape

to

secure

probe

placement. Some

vendors

use

visual

images

such

as

a

star

or

bar

to

specify

which

side

of

the

probe

should

be

placed

on

the

top

of

the

hand

or

foot. Pulse

oximetry

equipment

used

for

CCHD

Screening: Must

be

approved

by

the

FDA

for

use

in

newborns. Must

be

validated

in

low-perfusion

conditions. Must

have

2%

root,

mean-square

accuracy. Must

be

calibrated

regularly

based

on

manufacturer

guidelines. Masimo

Corporation

2011. FDA

CLEARANCE

FOR

PULSE

OXIMETER

USE

IN

NEONATES
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm
MICHIGAN

CCHD

SCREENING
PERFORMING

PULSE

OX-
PULSE

OX

DO’s

If

you

are

using

disposable

pulse

ox

probes,

use

a

new,

clean

probe

for

each

infant. If

you

are

using

reusable

pulse

ox

probes,

clean

the

probe

with

recommended

disinfectant

solution

between

each

infant.

 PULSE OX PROBE PLACEMENT
PULSE

OX

PROBE

PLACEMENT

PULSE

OX

PROBE

PLACEMENT

EDUCATION

Pulse

oximetry

equipment

used

for

CCHD

Screening:

FDA

CLEARANCE

FOR

PULSE

OXIMETER

USE

IN

NEONATES

PERFORMING

PULSE

OX-

PULSE

OX

DO’s

PULSE

OX

DON’Ts

PULSE

OX

CAUTION

CRITICAL

CONGENITAL

HEART

DEFECTS:

Pulse

oximetry

screening

is

most

likely

to

detect

seven

of

the

CCHDs.

These

seven

main

screening

targets

are:

D-transposition

of

the

Great

Arteries

Tetralogy

of

Fallot

Total

anomalous

pulmonary

venous

return

(TAPVC)

Truncus

Arteriosus

Hypoplastic

Left

Heart

Syndrome

(HLHS)

Pulmonary

Atresia

Tricuspid

Atresia

These

defects

are

less

likely

to

be

detected

through

pulse

oximetry

screening:

Coarctation

of

the

Aorta

Ebstein

Anomaly

Double-outlet

right

Ventricle

Interrupted

aortic

arch

Single

ventricle

SUGGESTED

RESOURCES

FOR

PROVIDERS

Michigan

Department

of

Community

Health

Atlanta

Children’s

Hospital

*

American

Academy

of

Pediatrics

American

Heart

Association

Children’s

National

Medical

Center
-
Washington

DC
*

Children’s

Hospital

of

Philadelphia

(CHOP)*

Cincinnati

Children’s

Hospital

*

Center

for

Disease

Control

and

Prevention

Congenital

Heart

Information

Network*

Baby’s

First

Test
*

MICHIGAN

Treatment

Centers

for

CCHD:

Children’s

Hospital

of

Michigan
Helen

DeVos

Children’s

Hospital
3901

Beaubien
Congenital

Heart

Center

Congenital

Heart

Center

at

C.S.

Mott

Children’s

Hospital

It

is

not

recommended

to

use

tape

to

secure

probe

placement. Some

vendors

use

visual

images

such

as

a

star

or

bar

to

specify

which

side

of

the

probe

should

be

placed

on

the

top

of

the

hand

or

foot. Pulse

oximetry

equipment

used

for

CCHD

Screening: Must

be

approved

by

the

FDA

for

use

in

newborns. Must

be

validated

in

low-perfusion

conditions. Must

have

2%

root,

mean-square

accuracy. Must

be

calibrated

regularly

based

on

manufacturer

guidelines. Masimo

Corporation

2011. FDA

CLEARANCE

FOR

PULSE

OXIMETER

USE

IN

NEONATES
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm
MICHIGAN

CCHD

SCREENING
PERFORMING

PULSE

OX-
PULSE

OX

DO’s

If

you

are

using

disposable

pulse

ox

probes,

use

a

new,

clean

probe

for

each

infant. If

you

are

using

reusable

pulse

ox

probes,

clean

the

probe

with

recommended

disinfectant

solution

between

each

infant.

Screening for Critical Congenital Heart Defects | CDC Screening for Critical Congenital Heart Defects
Screening for Critical Congenital Heart Defects
Importance of Newborn Screening for Critical Congenital Heart Defects
Number of Babies that Screening Can Help
Jodi's Story
Importance of Critical CHD Diagnosis Before Leaving the Hospital
Costs
Newborn Screening Contingency Plan, Version II, 2017
References
 Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the AHA and AAP. Pediatrics. 2009; 124:823-36. De-Wahl Granelli A, Wennergren M, Sandberg K, Mellander M, Bejlum C, Inganas L, Eriksson M, Segerdahl N, Agren A, Ekman-Joelsson BM, Sunnegardh J, Verdicchio M, Sotman-Smith I. Impact of pulse-oximetry screening on the detection of duct-dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns. BMJ. 2009; 338:

Screening for Critical Congenital Heart Defects | CDC

Screening for Critical Congenital Heart Defects
Screening for Critical Congenital Heart Defects
Importance of Newborn Screening for Critical Congenital Heart Defects
Number of Babies that Screening Can Help
Jodi's Story
Importance of Critical CHD Diagnosis Before Leaving the Hospital
Costs
Newborn Screening Contingency Plan, Version II, 2017
References

Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the AHA and AAP. Pediatrics. 2009; 124:823-36. De-Wahl Granelli A, Wennergren M, Sandberg K, Mellander M, Bejlum C, Inganas L, Eriksson M, Segerdahl N, Agren A, Ekman-Joelsson BM, Sunnegardh J, Verdicchio M, Sotman-Smith I. Impact of pulse-oximetry screening on the detection of duct-dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns. BMJ. 2009; 338:

Pulse oximetry - Wikipedia Pulse oximetry
Pulse oximetry
Contents
History
Function
Mode of operation
Indication
Advantages
Limitations
Equipment
Early detection of COVID-19
Derived measurements
See also
Notes
References
External links
 fluid volumes that are too low (under-hydration) or too high (over-hydration) have been shown to decrease wound healing and increase the risk of infection or cardiac complications. Recently, the National Health Service in the United Kingdom and the French Anesthesia and Critical Care Society listed PVI monitoring as part of their suggested strategies for intra-operative fluid management. In 2011, an expert workgroup recommended newborn screening with pulse oximetry to increase the detection of critical congenital heart disease (CCHD). The CCHD workgroup cited the results of two large, prospective studies of 59,876 subjects that exclusively used signal extraction technology to increase the identification of CCHD with minimal false positives. The CCHD workgroup recommended newborn screening be performed with motion tolerant pulse oximetry that has also been validated in low perfusion conditions. In 2011, the US Secretary of Health and Human Services added pulse oximetry to the recommended uniform screening panel. Before the evidence for screening using signal extraction technology, less than 1% of newborns in the United States were screened. Today, The Newborn Foundation has documented near universal screening in the United States and international screening is rapidly expanding. In 2014, a third large study of 122,738 newborns that also exclusively used signal extraction technology showed similar, positive results as the first two large studies. High-resolution pulse oximetry (HRPO) has been developed for in-home sleep apnea screening and testing in patients for whom it is impractical to perform polysomnography.

Pulse oximetry - Wikipedia

Pulse oximetry
Pulse oximetry
Contents
History
Function
Mode of operation
Indication
Advantages
Limitations
Equipment
Early detection of COVID-19
Derived measurements
See also
Notes
References
External links

fluid volumes that are too low (under-hydration) or too high (over-hydration) have been shown to decrease wound healing and increase the risk of infection or cardiac complications. Recently, the National Health Service in the United Kingdom and the French Anesthesia and Critical Care Society listed PVI monitoring as part of their suggested strategies for intra-operative fluid management. In 2011, an expert workgroup recommended newborn screening with pulse oximetry to increase the detection of critical congenital heart disease (CCHD). The CCHD workgroup cited the results of two large, prospective studies of 59,876 subjects that exclusively used signal extraction technology to increase the identification of CCHD with minimal false positives. The CCHD workgroup recommended newborn screening be performed with motion tolerant pulse oximetry that has also been validated in low perfusion conditions. In 2011, the US Secretary of Health and Human Services added pulse oximetry to the recommended uniform screening panel. Before the evidence for screening using signal extraction technology, less than 1% of newborns in the United States were screened. Today, The Newborn Foundation has documented near universal screening in the United States and international screening is rapidly expanding. In 2014, a third large study of 122,738 newborns that also exclusively used signal extraction technology showed similar, positive results as the first two large studies. High-resolution pulse oximetry (HRPO) has been developed for in-home sleep apnea screening and testing in patients for whom it is impractical to perform polysomnography.

Pulse Oximetry Screening for Babies Pulse Oximetry Screening for Babies
Pulse Oximetry Screening for Babies
How Is a Pulse Oximetry Test Performed?
Is Pulse Oximetry Testing Safe?
Why Is Pulse Oximetry Testing Important?
 Pulse Oximetry Screening for Babies
Pulse Oximetry Screening for Babies
Email
Print
12/20/2014
<%url:"/resources/flash/WilliamsPulseOximetry.flv",title:"Learn About Pulse Oximetry Screenings and Their Life-Saving Benefits",mode:"transparent" %>
A pulse oximetry reading, such as the one shown here, indicates the percentage of hemoglobin in the red blood cells that contains oxygen. Normal is over 95%, while babies with heart defects can have saturations from 60% to 94%, or there may be a significant difference between saturations measured in the arms and legs. Babies who have a positive pulse oximetry screening should be evaluated by a pediatric cardiologist. A pulse oximetry screen is a noninvasive (and painless) test performed on all newborn babies to determine the level of oxygen in their blood. This test uses rays of light of different wavelengths to measure the percent of hemoglobin (the part of blood that carries oxygen) that is filled with oxygen. Normally, a newborn baby should have an oxygen saturation level that is greater than 95%. Screening using pulse oximetry can detect some infants with congenital heart disease who otherwise may go undetected for a while. There are some congenital heart defects that cause a newborn baby to have lower oxygen saturation in the blood after birth. It often can be difficult to determine if a baby has cyanosis ( bluish discoloration of the skin due to poor oxygen content of the blood) just by looking at him or her after birth. How Is a Pulse Oximetry Test Performed?

Pulse Oximetry Screening for Babies

Pulse Oximetry Screening for Babies
Pulse Oximetry Screening for Babies
How Is a Pulse Oximetry Test Performed?
Is Pulse Oximetry Testing Safe?
Why Is Pulse Oximetry Testing Important?

Pulse Oximetry Screening for Babies
Pulse Oximetry Screening for Babies
Email
Print
12/20/2014
<%url:"/resources/flash/WilliamsPulseOximetry.flv",title:"Learn About Pulse Oximetry Screenings and Their Life-Saving Benefits",mode:"transparent" %>
A pulse oximetry reading, such as the one shown here, indicates the percentage of hemoglobin in the red blood cells that contains oxygen. Normal is over 95%, while babies with heart defects can have saturations from 60% to 94%, or there may be a significant difference between saturations measured in the arms and legs. Babies who have a positive pulse oximetry screening should be evaluated by a pediatric cardiologist. A pulse oximetry screen is a noninvasive (and painless) test performed on all newborn babies to determine the level of oxygen in their blood. This test uses rays of light of different wavelengths to measure the percent of hemoglobin (the part of blood that carries oxygen) that is filled with oxygen. Normally, a newborn baby should have an oxygen saturation level that is greater than 95%. Screening using pulse oximetry can detect some infants with congenital heart disease who otherwise may go undetected for a while. There are some congenital heart defects that cause a newborn baby to have lower oxygen saturation in the blood after birth. It often can be difficult to determine if a baby has cyanosis ( bluish discoloration of the skin due to poor oxygen content of the blood) just by looking at him or her after birth. How Is a Pulse Oximetry Test Performed?

 Congenital Heart Disease Screening Program Toolkit
A Toolkit for Implementing Screening •2nd Edition
Congenital Heart Disease Screening Program Toolkit
This material is made possible by the Elsie and Marvin Dekelboum Family Foundation. CongHrt_Cover&Tabs9x11  10/11/11  12:55 PM  Page 1
Acknowledgements
This material was made possible by a grant from the Elsie and Marvin Dekelboum Family Foundation. The Children’s National Heart Institute and Child Health Advocacy Institute would like to express sincere gratitude to the Dekelboum Family Foundation for their support in the launch of this initiative. We would also like to thank the following Children’s National Medical Center departments and programs for their assistance in the development of this Toolkit: • Language Services • Legal Department • Public Relations & Marketing Department • Patient and Family Education • Patient and Family Advisory Board • Biomedical Engineering • Nursing Staff Development Special acknowledgements are also given to the following: • Mona Barmash, Children’s Heart Information Network • Holy Cross Hospital
CongHrt_Cover&Tabs9x11  10/11/11  12:56 PM  Page 2
User Agreement
♥Section 1 – Program Overview
Vision Pulse Oximetry Screening for Congenital Heart Disease: Who, What, When, Where, and Why? Opening Letter Screening Recommendations Letter to Providers Supplies for Screening Screening Form ♥Section 2 – Screener Training
In-Service Education Program Components Congenital Heart Disease Screening Program: Education for Providers Performing Pulse Oximetry with the Infant Patient: Education for Providers Pulse Ox Probe Placement Education Knowledge Assessment and Answer Key Competency Check List Training Log CHDSP PowerPoint Presentation Information ♥Section 3 – Education for Parents and Guardians
Checklist for Informing Mothers Frequently Asked Questions (FAQs) for Patients and Families Frequently Asked Questions (FAQs) for Patients and Families (Spanish) Congenital Heart Disease Screening Program:

DHHS: DPH: WCH: Families: Newborn Screening WCH: Newborn Screening
WCH: Newborn Screening
Families
What is Newborn Metabolic Screening?
Critical Congenital Heart Defects (CCHD) Screening
Severe Combined Immunodeficiency (SCID) Fact Sheets for Parents and Providers
Who is Eligible?
How to Apply
Contacts
 Your baby did not pass the pulse oximetry screen (PDF, 614 KB)
Resultado No Pasó: Su bebé no pasó la prueba de oximetría de pulso (PDF, 515 KB)
Pass Result: Your baby passed the pulse oximetry screen! ( PDF, 551 KB)
Su bebé pasó la prueba de oximetría de pulso (PDF, 292 KB)
American Heart Association: Pulse Oximetry Screening for CCHD
Children’s National Medical Center: Pulse Ox Congenital Heart Disease Screening
Educational Videos about CCHD Screening
Baby’s First Test: Heart Smart Videos for Parents (English, Spanish, Arabic, Chinese, French, and Russian)
Information for Hospitals and Providers
CCHD Continuing Education Webinars
Critical Congenital Heart Disease Screening in North Carolina - CCHD Screening Part 1
Safe and Effective CCHD Screening in North Carolina - CCHD Series Part 2
CCHD Permanent Rules
CCHD Screening and Reporting Outreach Letter for Providers (PDF, 61 KB)
CCHD Screening Recommendations from the American Academy of Pediatrics
Perinatal Quality Collaborative of NC (PQCNC): Online CCHD database for all reporting
A Model Toolkit for Hospitals to Learn about the Nationally Recommended CCHD Screening Protocol and Process
Children’s National Medical Center CCHD Screening Toolkit
Severe Combined Immunodeficiency (SCID) Fact Sheets for Parents and Providers
SCID Fact Sheet for Parents (PDF, 45 KB)
SCID Fact Sheet for Primary Care Providers (PDF, 298 KB)
Severe Combined Immune Deficiency: A Guide for Parents Following a Diagnosis
Deficiencia Inmunológica Combinada Severa (SCID): Una Guía para Padres Después del Diagnóstico
Hoja Informativa de SCID para Proveedores de Atención Primaria (Spanish;

DHHS: DPH: WCH: Families: Newborn Screening

WCH: Newborn Screening
WCH: Newborn Screening
Families
What is Newborn Metabolic Screening?
Critical Congenital Heart Defects (CCHD) Screening
Severe Combined Immunodeficiency (SCID) Fact Sheets for Parents and Providers
Who is Eligible?
How to Apply
Contacts

Your baby did not pass the pulse oximetry screen (PDF, 614 KB)
Resultado No Pasó: Su bebé no pasó la prueba de oximetría de pulso (PDF, 515 KB)
Pass Result: Your baby passed the pulse oximetry screen! ( PDF, 551 KB)
Su bebé pasó la prueba de oximetría de pulso (PDF, 292 KB)
American Heart Association: Pulse Oximetry Screening for CCHD
Children’s National Medical Center: Pulse Ox Congenital Heart Disease Screening
Educational Videos about CCHD Screening
Baby’s First Test: Heart Smart Videos for Parents (English, Spanish, Arabic, Chinese, French, and Russian)
Information for Hospitals and Providers
CCHD Continuing Education Webinars
Critical Congenital Heart Disease Screening in North Carolina - CCHD Screening Part 1
Safe and Effective CCHD Screening in North Carolina - CCHD Series Part 2
CCHD Permanent Rules
CCHD Screening and Reporting Outreach Letter for Providers (PDF, 61 KB)
CCHD Screening Recommendations from the American Academy of Pediatrics
Perinatal Quality Collaborative of NC (PQCNC): Online CCHD database for all reporting
A Model Toolkit for Hospitals to Learn about the Nationally Recommended CCHD Screening Protocol and Process
Children’s National Medical Center CCHD Screening Toolkit
Severe Combined Immunodeficiency (SCID) Fact Sheets for Parents and Providers
SCID Fact Sheet for Parents (PDF, 45 KB)
SCID Fact Sheet for Primary Care Providers (PDF, 298 KB)
Severe Combined Immune Deficiency: A Guide for Parents Following a Diagnosis
Deficiencia Inmunológica Combinada Severa (SCID): Una Guía para Padres Después del Diagnóstico
Hoja Informativa de SCID para Proveedores de Atención Primaria (Spanish;

Respiratory Distress in Children: Signs All Parents Need to Know Signs Of Respiratory Distress In Children All Parents Need To Know
Don’t miss a thing!
Oh hey there!
What Parents Need To Know About Coronavirus
Signs Of Respiratory Distress In Children All Parents Need To Know
Symptoms of Respiratory Distress in Children
Tachypnea – Fast Breathing
This is a good example of a child who has tachypnea and retractions:
Low Pulse Oximetry And Respiratory Distress
Wheezing
Here are two good examples of children who are wheezing:
Retractions
Subcostal Retractions occur toward the bottom of the ribs.
Substernal Retractions occur at the bottom of the sternum.
Intercostal retractions occur in-between your child’s ribs.
Suprasternal retractions occur at the top of the sternum.
Supraclavicular retractions occur right above the clavicles (collarbones)
Grunting
Stridor
Nasal Flaring
Color Changes
Changes in alertness
Progression Of Respiratory Distress to Respiratory Failure In Children
« 10 Myths Every Feeding Tube Family Wants You to Know
20 Safe Pediatric Products For Fighting Your Child’s Common Cold »
be informed.
get the newsletter
 Most healthy children average from 97-100% at any given time. If a child’s pulse oximetry is below 95%, they should be evaluated by your pediatric provider. Medical grade pulse oximeters available at hospitals and medical offices provide the most accurate readings, however, there are some home models that can be helpful for some parents. For children ages 2 and older, I like using this Acc U Rate pulse oximeter for children. Infants’ fingers are too small for a classic finger model. I think the best commercially available pulse oximeter for infants is the Owlet smart sock. It’s important to note that pulse oximetry is just one way of evaluating a child’s respiratory function. It is only one piece of the overall picture. All of the other signs and symptoms described in this post are just as important. Monitoring pulse oximeter tends to be most helpful for children who are prone to respiratory illnesses or asthma, but many of the parents I work with find it helpful to have on hand when trying to decide if their child has a common cough or if they need further medical attention.

Respiratory Distress in Children: Signs All Parents Need to Know

Signs Of Respiratory Distress In Children All Parents Need To Know
Don’t miss a thing!
Oh hey there!
What Parents Need To Know About Coronavirus
Signs Of Respiratory Distress In Children All Parents Need To Know
Symptoms of Respiratory Distress in Children
Tachypnea – Fast Breathing
This is a good example of a child who has tachypnea and retractions:
Low Pulse Oximetry And Respiratory Distress
Wheezing
Here are two good examples of children who are wheezing:
Retractions
Subcostal Retractions occur toward the bottom of the ribs.
Substernal Retractions occur at the bottom of the sternum.
Intercostal retractions occur in-between your child’s ribs.
Suprasternal retractions occur at the top of the sternum.
Supraclavicular retractions occur right above the clavicles (collarbones)
Grunting
Stridor
Nasal Flaring
Color Changes
Changes in alertness
Progression Of Respiratory Distress to Respiratory Failure In Children
« 10 Myths Every Feeding Tube Family Wants You to Know
20 Safe Pediatric Products For Fighting Your Child’s Common Cold »
be informed.
get the newsletter

Most healthy children average from 97-100% at any given time. If a child’s pulse oximetry is below 95%, they should be evaluated by your pediatric provider. Medical grade pulse oximeters available at hospitals and medical offices provide the most accurate readings, however, there are some home models that can be helpful for some parents. For children ages 2 and older, I like using this Acc U Rate pulse oximeter for children. Infants’ fingers are too small for a classic finger model. I think the best commercially available pulse oximeter for infants is the Owlet smart sock. It’s important to note that pulse oximetry is just one way of evaluating a child’s respiratory function. It is only one piece of the overall picture. All of the other signs and symptoms described in this post are just as important. Monitoring pulse oximeter tends to be most helpful for children who are prone to respiratory illnesses or asthma, but many of the parents I work with find it helpful to have on hand when trying to decide if their child has a common cough or if they need further medical attention.

DHHS: DPH: WCH: Families: Newborn Screening WCH: Newborn Screening
WCH: Newborn Screening
Families
What is Newborn Metabolic Screening?
Critical Congenital Heart Defects (CCHD) Screening
Severe Combined Immunodeficiency (SCID) Fact Sheets for Parents and Providers
Who is Eligible?
How to Apply
Contacts
 This screening is typically performed at hospitals. + Critical Congenital Heart Defects Resources
General Information for Parents About CCHD
Information for Families (PDF, 570 KB)
Información para las Familias (PDF, 575 KB)
Centers for Disease Control and Prevention: Facts about CCHD
Common Tests for Congenital Heart Defects (American Heart Association)
March of Dimes: Congenital Heart Defects and CCHD Information
Wisconsin Shine Program: Information for Families in English and Spanish
Information about CCHD Screening
Did Not Pass Result: Your baby did not pass the pulse oximetry screen (PDF, 614 KB)
Resultado No Pasó: Su bebé no pasó la prueba de oximetría de pulso (PDF, 515 KB)
Pass Result: Your baby passed the pulse oximetry screen! ( PDF, 551 KB)
Su bebé pasó la prueba de oximetría de pulso (PDF, 292 KB)
American Heart Association: Pulse Oximetry Screening for CCHD
Children’s National Medical Center:

This screening is typically performed at hospitals. + Critical Congenital Heart Defects Resources
General Information for Parents About CCHD
Information for Families (PDF, 570 KB)
Información para las Familias (PDF, 575 KB)
Centers for Disease Control and Prevention: Facts about CCHD
Common Tests for Congenital Heart Defects (American Heart Association)
March of Dimes: Congenital Heart Defects and CCHD Information
Wisconsin Shine Program: Information for Families in English and Spanish
Information about CCHD Screening
Did Not Pass Result: Your baby did not pass the pulse oximetry screen (PDF, 614 KB)
Resultado No Pasó: Su bebé no pasó la prueba de oximetría de pulso (PDF, 515 KB)
Pass Result: Your baby passed the pulse oximetry screen! ( PDF, 551 KB)
Su bebé pasó la prueba de oximetría de pulso (PDF, 292 KB)
American Heart Association: Pulse Oximetry Screening for CCHD
Children’s National Medical Center:

Newborn Screening Procedures | Baby's First Test | Newborn Screening | Baby Health Screening Procedures
Your Baby’s Screening Screening Procedures
What are the screening procedures?
Blood Test:
Hearing Screen:
Pulse Oximetry Testing:
Why are all babies screened at birth?
Do parents have to ask for screening?
When does the screen happen?
How will parents find out the results?
How are screening costs covered?
Newborn Screening and Home Births
Newborn Screening for Preterm, Low Birth Weight, NICU or Sick Newborns
Newborn Screening and Adoption
Newborn Screening for Military Families
Additional Questions
Looking for more specific information?
Find a condition What your state offers
 To find contact information for your state's Early Hearing Detection and Intervention (EHDI) program, click here. Pulse Oximetry Testing: Pulse oximetry, or pulse ox, is a non-invasive
A medical test or procedure that does not require a doctor to insert any device through the skin or into a body opening
test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, using a painless sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. Why are all babies screened at birth? Most babies are born healthy. However, some infants have a serious medical condition even though they look and act like all newborns. These babies generally come from families with no previous history of a condition.

Newborn Screening Procedures | Baby's First Test | Newborn Screening | Baby Health

Screening Procedures
Your Baby’s Screening Screening Procedures
What are the screening procedures?
Blood Test:
Hearing Screen:
Pulse Oximetry Testing:
Why are all babies screened at birth?
Do parents have to ask for screening?
When does the screen happen?
How will parents find out the results?
How are screening costs covered?
Newborn Screening and Home Births
Newborn Screening for Preterm, Low Birth Weight, NICU or Sick Newborns
Newborn Screening and Adoption
Newborn Screening for Military Families
Additional Questions
Looking for more specific information?
Find a condition What your state offers

To find contact information for your state's Early Hearing Detection and Intervention (EHDI) program, click here. Pulse Oximetry Testing: Pulse oximetry, or pulse ox, is a non-invasive
A medical test or procedure that does not require a doctor to insert any device through the skin or into a body opening
test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, using a painless sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. Why are all babies screened at birth? Most babies are born healthy. However, some infants have a serious medical condition even though they look and act like all newborns. These babies generally come from families with no previous history of a condition.

Masimo - CCHD Screening CCHD Screening with Pulse Oximetry
CCHD Screening with Pulse Oximetry
Critical Congenital Heart Disease
CCHD Screening with Pulse Oximetry
Why is it Important to use Masimo SET ® Pulse Oximetry for CCHD Screening?
Performance During Motion and Low Perfusion 12
Improved Critical Congenital Heart Disease Screening Sensitivity vs. Clinical Assessment Alone 5
How to Conduct CCHD Screening with Pulse Oximetry
Masimo Solutions for CCHD Screening with Pulse Oximetry
Learn More About CCHD Screening with Masimo SET ®
RESOURCES
CCHD Screening with Pulse Oximetry Solutions
CCHD Screening
Masimo SET
 15. Ewer AK et al. Lancet. 2011 Aug 27;378 (9793):785-94. RESOURCES
CCHD Screening with Pulse Oximetry Solutions
Brochure
CCHD Screening
Instructional Guide
Masimo SET
Product Information
View Clinical Evidence
Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. See instructions for use for full prescribing information, including indications, contraindications, warnings, and precautions.

Masimo - CCHD Screening

15. Ewer AK et al. Lancet. 2011 Aug 27;378 (9793):785-94. RESOURCES
CCHD Screening with Pulse Oximetry Solutions
Brochure
CCHD Screening
Instructional Guide
Masimo SET
Product Information
View Clinical Evidence
Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. See instructions for use for full prescribing information, including indications, contraindications, warnings, and precautions.

 false positives and negatives; and main costs are incurred by follow-up testing to the pulse oximetry screening. COSTS
Many hospitals already have pulse oximetry machines and the only additional cost is for use of the probe which is about $1 per reusable probe, or $7 to $8 for a single-use probe, according to the Children's National Medical Center. New Jersey (see below) estimates a cost of $10 per screening. A screening may be repeated if test results show the blood is lacking oxygen, and then more expensive ultrasounds or echocardiograms would be performed. Nursing time required to do pulse oximetry testing on newborns averages about three minutes per baby. Some critics of mandatory pulse oximetry screening raise the issue of the added cost of echocardiography in false-positive cases. FEDERAL RECOMMENDATIONS
Requiring pulse oximetry screening for newborns has been a state level issue for several years with proposals to have it included with other mandatory screenings for newborns. In October 2010, the Department HHS Advisory Committee on Heritable Diseases in Newborns and Children made a recommendation to add CHD to the uniform screening panel. It stated that “although there are recognizable evidence gaps, there are compelling reasons for recommending newborns for CHD.”

false positives and negatives; and main costs are incurred by follow-up testing to the pulse oximetry screening. COSTS
Many hospitals already have pulse oximetry machines and the only additional cost is for use of the probe which is about $1 per reusable probe, or $7 to $8 for a single-use probe, according to the Children's National Medical Center. New Jersey (see below) estimates a cost of $10 per screening. A screening may be repeated if test results show the blood is lacking oxygen, and then more expensive ultrasounds or echocardiograms would be performed. Nursing time required to do pulse oximetry testing on newborns averages about three minutes per baby. Some critics of mandatory pulse oximetry screening raise the issue of the added cost of echocardiography in false-positive cases. FEDERAL RECOMMENDATIONS
Requiring pulse oximetry screening for newborns has been a state level issue for several years with proposals to have it included with other mandatory screenings for newborns. In October 2010, the Department HHS Advisory Committee on Heritable Diseases in Newborns and Children made a recommendation to add CHD to the uniform screening panel. It stated that “although there are recognizable evidence gaps, there are compelling reasons for recommending newborns for CHD.”

Newborn Screening Process | Newborn Screening Newborn Screening Process
Newborn Screening Process
When Does Newborn Screening Happen?
Where Does NBS Happen?
How Does NBS Happen?
Blood Spot Screening
Pulse Oximetry Screening
Hearing Screening
Is NBS the Same for All Babies in the U.S.?
Parent Options During Screening
Differences in the Newborn Screening Panel
Before Newborn Screening: Questions to Ask
 Measuring your baby’s blood oxygen level can help see if your baby needs urgent heart treatment. Following is a step-by-step guide explaining how pulse oximetry screening happens: Between 24 and 48 hours after birth, a health care provider will tell you that it is time for your newborn’s pulse oximetry screening. The health care provider will place a small wrap on your baby’s skin, usually around the right hand or wrist and on either foot. One side of the wrap has a light, and the other has a sensor. The health care provider will connect the wrap to a monitor that uses the sensor’s reading to calculate how much oxygen is in your baby’s blood. Using the numbers on this monitor, the health care provider can tell whether your baby might have CCHD. Babies who do not pass pulse oximetry screening the first time may repeat it or may need further testing. Results from pulse oximetry screening are ready as soon as the screening is done. If your baby does not pass pulse oximetry screening, a health care provider may recommend more testing to see if your baby’s heart and lungs are working well.

Newborn Screening Process | Newborn Screening

Newborn Screening Process
Newborn Screening Process
When Does Newborn Screening Happen?
Where Does NBS Happen?
How Does NBS Happen?
Blood Spot Screening
Pulse Oximetry Screening
Hearing Screening
Is NBS the Same for All Babies in the U.S.?
Parent Options During Screening
Differences in the Newborn Screening Panel
Before Newborn Screening: Questions to Ask

Measuring your baby’s blood oxygen level can help see if your baby needs urgent heart treatment. Following is a step-by-step guide explaining how pulse oximetry screening happens: Between 24 and 48 hours after birth, a health care provider will tell you that it is time for your newborn’s pulse oximetry screening. The health care provider will place a small wrap on your baby’s skin, usually around the right hand or wrist and on either foot. One side of the wrap has a light, and the other has a sensor. The health care provider will connect the wrap to a monitor that uses the sensor’s reading to calculate how much oxygen is in your baby’s blood. Using the numbers on this monitor, the health care provider can tell whether your baby might have CCHD. Babies who do not pass pulse oximetry screening the first time may repeat it or may need further testing. Results from pulse oximetry screening are ready as soon as the screening is done. If your baby does not pass pulse oximetry screening, a health care provider may recommend more testing to see if your baby’s heart and lungs are working well.

Screening Newborns for Critical Congenital Heart Disease Screening Newborns for Critical Congenital Heart Disease
Screening Newborns for Critical Congenital Heart Disease If the birth facility screens for CCHDs, make sure that all of your newborn patients are appropriately screened. If screening is mandated by your state, but your patient was not appropriately screened at the birth facility, develop strategies for screening in your office. If screening is not mandated in your state and your clinic has the equipment and would like to screen your asymptomatic patients who were not screened in their birth facility, you are certainly welcome to do so. However, you should first have a plan in place for what steps to take in the event that one of your patients fails the screening test. It is important to remember that pulse oximetry screening is just 1 additional tool to detect children with CCHDs. It is not intended to replace taking a complete family health and pregnancy history, and completing a physical examination of the newborn, which sometimes can detect CCHDs before the development of hypoxemia or can detect children whose CCHDs are missed by pulse oximetry. Realize that pulse oximetry screening does not detect all CCHDs, even all of the 7 main screening targets. A "passed" screen does not rule out the possibility of a CCHD or other heart defect in your patient. For every 3 children detected with a CCHD by screening, 1 child with a CCHD will still be missed. Continued vigilance is necessary to recognize congenital heart defects if signs or symptoms, such as tachypnea, cyanosis, weak pulses, failure to thrive, extreme sleepiness, or a heart murmur, occur.

If the birth facility screens for CCHDs, make sure that all of your newborn patients are appropriately screened. If screening is mandated by your state, but your patient was not appropriately screened at the birth facility, develop strategies for screening in your office. If screening is not mandated in your state and your clinic has the equipment and would like to screen your asymptomatic patients who were not screened in their birth facility, you are certainly welcome to do so. However, you should first have a plan in place for what steps to take in the event that one of your patients fails the screening test. It is important to remember that pulse oximetry screening is just 1 additional tool to detect children with CCHDs. It is not intended to replace taking a complete family health and pregnancy history, and completing a physical examination of the newborn, which sometimes can detect CCHDs before the development of hypoxemia or can detect children whose CCHDs are missed by pulse oximetry. Realize that pulse oximetry screening does not detect all CCHDs, even all of the 7 main screening targets. A "passed" screen does not rule out the possibility of a CCHD or other heart defect in your patient. For every 3 children detected with a CCHD by screening, 1 child with a CCHD will still be missed. Continued vigilance is necessary to recognize congenital heart defects if signs or symptoms, such as tachypnea, cyanosis, weak pulses, failure to thrive, extreme sleepiness, or a heart murmur, occur.

  PULSE OX PROBE PLACEMENT
PULSE

OX

PROBE

PLACEMENT

PULSE

OX

PROBE

PLACEMENT

EDUCATION

Pulse

oximetry

equipment

used

for

CCHD

Screening:

FDA

CLEARANCE

FOR

PULSE

OXIMETER

USE

IN

NEONATES

PERFORMING

PULSE

OX-

PULSE

OX

DO’s

PULSE

OX

DON’Ts

PULSE

OX

CAUTION

CRITICAL

CONGENITAL

HEART

DEFECTS:

Pulse

oximetry

screening

is

most

likely

to

detect

seven

of

the

CCHDs.

These

seven

main

screening

targets

are:

D-transposition

of

the

Great

Arteries

Tetralogy

of

Fallot

Total

anomalous

pulmonary

venous

return

(TAPVC)

Truncus

Arteriosus

Hypoplastic

Left

Heart

Syndrome

(HLHS)

Pulmonary

Atresia

Tricuspid

Atresia

These

defects

are

less

likely

to

be

detected

through

pulse

oximetry

screening:

Coarctation

of

the

Aorta

Ebstein

Anomaly

Double-outlet

right

Ventricle

Interrupted

aortic

arch

Single

ventricle

SUGGESTED

RESOURCES

FOR

PROVIDERS

Michigan

Department

of

Community

Health

Atlanta

Children’s

Hospital

*

American

Academy

of

Pediatrics

American

Heart

Association

Children’s

National

Medical

Center
-
Washington

DC
*

Children’s

Hospital

of

Philadelphia

(CHOP)*

Cincinnati

Children’s

Hospital

*

Center

for

Disease

Control

and

Prevention

Congenital

Heart

Information

Network*

Baby’s

First

Test
*

MICHIGAN

Treatment

Centers

for

CCHD:

Children’s

Hospital

of

Michigan
Helen

DeVos

Children’s

Hospital
3901

Beaubien
Congenital

Heart

Center

Congenital

Heart

Center

at

C.S.

Mott

Children’s

Hospital

 PULSE

OX

CAUTION

A

pulse

is

needed

to

determine

the

oximetry

reading. Pulse

ox

is

not

accurate

if

the

patient

is

coding

or

has

a

cardiac

arrhythmia. Remember: No

pulse,

no

oximetry! Pulse

ox

readings

are

not

instantaneous. The

oximetry

reading

that

is

displayed

on

the

monitor

is

an

average

of

readings

over

the

past

few

seconds. CRITICAL

CONGENITAL

HEART

DEFECTS: Pulse

oximetry

screening

is

most

likely

to

detect

seven

of

the

CCHDs. These

seven

main

screening

targets

are: D-transposition

of

the

Great

Arteries

heart

in

which

the

two

main

arteries

carrying

blood

away

from

the

heart

are

reversed.

PULSE

OX

CAUTION

A

pulse

is

needed

to

determine

the

oximetry

reading. Pulse

ox

is

not

accurate

if

the

patient

is

coding

or

has

a

cardiac

arrhythmia. Remember: No

pulse,

no

oximetry! Pulse

ox

readings

are

not

instantaneous. The

oximetry

reading

that

is

displayed

on

the

monitor

is

an

average

of

readings

over

the

past

few

seconds. CRITICAL

CONGENITAL

HEART

DEFECTS: Pulse

oximetry

screening

is

most

likely

to

detect

seven

of

the

CCHDs. These

seven

main

screening

targets

are: D-transposition

of

the

Great

Arteries

heart

in

which

the

two

main

arteries

carrying

blood

away

from

the

heart

are

reversed.

Masimo - CCHD Screening CCHD Screening with Pulse Oximetry
CCHD Screening with Pulse Oximetry
Critical Congenital Heart Disease
CCHD Screening with Pulse Oximetry
Why is it Important to use Masimo SET ® Pulse Oximetry for CCHD Screening?
Performance During Motion and Low Perfusion 12
Improved Critical Congenital Heart Disease Screening Sensitivity vs. Clinical Assessment Alone 5
How to Conduct CCHD Screening with Pulse Oximetry
Masimo Solutions for CCHD Screening with Pulse Oximetry
Learn More About CCHD Screening with Masimo SET ®
RESOURCES
CCHD Screening with Pulse Oximetry Solutions
CCHD Screening
Masimo SET
 Masimo - CCHD Screening
CCHD Screening with Pulse Oximetry
Home / Newborn Care / CCHD Screening
Critical Congenital Heart Disease
Congenital heart defects (CHDs) are the most common birth-related malformation. 1 Critical CHDs (CCHDs) are life threatening and account for nearly 25% of all CHDs. 2 Babies sent home with an undetected heart defect are at risk of serious complications within the first few days or weeks of life, requiring emergency care, 3 and even at risk of dying. CCHD Screening with Pulse Oximetry
Traditionally, following birth, newborns were observed for evidence of CHDs by physical assessment and monitoring for common symptoms. 1 Today, studies show that these methods alone can be unreliable and may fail to detect up to 36% of infants with CCHD before discharge. 4,5 Adding screening with pulse oximetry can help diagnose CCHD before an infant becomes symptomatic. 6
In 2011, following numerous studies observing the utility of pulse oximetry in screening for CCHD, a work group was convened to develop strategies for the implementation of safe, effective, and efficient CCHD screening with pulse oximetry. 7 The work group found sufficient evidence to recommend the use of pulse oximetry to screen for CCHD, and further recommended that screening be performed with motion-tolerant pulse oximeters that report functional oxygen saturation (SpO 2) and have been validated in low-perfusion conditions. 7
In a recent study, researchers found a 33% decrease in infant cardiac deaths after statewide implementation of mandatory policies for CCHD screening, compared with prior periods and states without policies, as well as a 21% decrease in early infant deaths from other/unspecified cardiac causes. 8
Why is it Important to use Masimo SET ® Pulse Oximetry for CCHD Screening?

Masimo - CCHD Screening

Ohio | Baby's First Test | Newborn Screening | Baby Health Ohio
States Ohio
Conditions Screened
The Ohio Program
Download Brochure
What Conditions are Screened For in Ohio?
Amino Acid Disorders
Endocrine Disorders
Fatty Acid Oxidation Disorders
Hemoglobin Disorders
Lysosomal Storage Disorders
Organic Acid Conditions
Other Disorders
About Newborn Screening in Ohio
Program Overview:
How is Newborn Screening Paid for in Ohio?
Policies and Resources
Support for families:
Storage and Use of Dried Blood Spots:
 By finding the medical problem soon after birth, babies quickly receive the treatment they need. Newborn screening improves the health and development of babies. Every year in Ohio, more than 500 newborns needing medical care are identified by newborn screening. Nearly 200 infants are identified as deaf or with hearing loss, an additional 80 infants are diagnosed with serious heart diseases, and about 300 more infants are identified with serious medical conditions that can be found by testing the baby’s blood. Babies born in Ohio have three different newborn screening tests done shortly after birth. A hearing screen to check to for hearing loss and a pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. screen to check for critical heart defects are usually done at the birth hospital the day after a baby is born.

By finding the medical problem soon after birth, babies quickly receive the treatment they need. Newborn screening improves the health and development of babies. Every year in Ohio, more than 500 newborns needing medical care are identified by newborn screening. Nearly 200 infants are identified as deaf or with hearing loss, an additional 80 infants are diagnosed with serious heart diseases, and about 300 more infants are identified with serious medical conditions that can be found by testing the baby’s blood. Babies born in Ohio have three different newborn screening tests done shortly after birth. A hearing screen to check to for hearing loss and a pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery. screen to check for critical heart defects are usually done at the birth hospital the day after a baby is born.

Newborn Screening Process | Newborn Screening Newborn Screening Process
Newborn Screening Process
When Does Newborn Screening Happen?
Where Does NBS Happen?
How Does NBS Happen?
Blood Spot Screening
Pulse Oximetry Screening
Hearing Screening
Is NBS the Same for All Babies in the U.S.?
Parent Options During Screening
Differences in the Newborn Screening Panel
Before Newborn Screening: Questions to Ask
 Pulse Oximetry Screening
Pulse oximetry screening uses a sensor to determine if your baby might have certain heart conditions called critical congenital heart disease (CCHD). CCHD is a group of serious heart conditions present at birth. Children with CCHD have any of a wide range of heart problems that arise when parts of the heart do not form correctly. In some forms of CCHD, the heart has trouble delivering oxygen from the lungs to the rest of the body. Babies with these forms of CCHD have low levels of oxygen in their blood. Measuring your baby’s blood oxygen level can help see if your baby needs urgent heart treatment. Following is a step-by-step guide explaining how pulse oximetry screening happens: Between 24 and 48 hours after birth, a health care provider will tell you that it is time for your newborn’s pulse oximetry screening. The health care provider will place a small wrap on your baby’s skin, usually around the right hand or wrist and on either foot. One side of the wrap has a light, and the other has a sensor.

Pulse Oximetry Screening
Pulse oximetry screening uses a sensor to determine if your baby might have certain heart conditions called critical congenital heart disease (CCHD). CCHD is a group of serious heart conditions present at birth. Children with CCHD have any of a wide range of heart problems that arise when parts of the heart do not form correctly. In some forms of CCHD, the heart has trouble delivering oxygen from the lungs to the rest of the body. Babies with these forms of CCHD have low levels of oxygen in their blood. Measuring your baby’s blood oxygen level can help see if your baby needs urgent heart treatment. Following is a step-by-step guide explaining how pulse oximetry screening happens: Between 24 and 48 hours after birth, a health care provider will tell you that it is time for your newborn’s pulse oximetry screening. The health care provider will place a small wrap on your baby’s skin, usually around the right hand or wrist and on either foot. One side of the wrap has a light, and the other has a sensor.

Critical Congenital Heart Disease | Ohio Department of Health Critical Congenital Heart Disease
Critical Congenital Heart Disease
Facts about Congenital Heart Disease
CCHD Resources
Contact Us
 Other heart defects can be just as severe as critical CCHD and may also require treatment soon after birth. How is Newborn Screening for CCHD Done? Newborn screening for CCHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood can be a sign of a CCHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby's right hand and one foot (either right or left). The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect CCHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Timing of CCHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age.

Other heart defects can be just as severe as critical CCHD and may also require treatment soon after birth. How is Newborn Screening for CCHD Done? Newborn screening for CCHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood can be a sign of a CCHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby's right hand and one foot (either right or left). The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect CCHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Timing of CCHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age.

 If early discharge is planned, screening should occur as late as possible. Where
should pulse ox screening be performed? Pulse ox screening should be performed while the infant is in the nursery, before he or she goes home. The pulse ox test should be performed on the right hand and one foot. Vision: All infants with critical congenital heart disease are detected before leaving the nursery. Vision Who, What, When, Where, and Why? Congenital Heart Disease Screening Program♥
8
Program Overview
Thank you for your interest in the Congenital Heart Disease Screening Program (CHDSP). We are excited to provide you with the resources that you will need to implement the CHDSP in your newborn nursery. The components of this program have been assembled by Children’s National Medical Center.

If early discharge is planned, screening should occur as late as possible. Where
should pulse ox screening be performed? Pulse ox screening should be performed while the infant is in the nursery, before he or she goes home. The pulse ox test should be performed on the right hand and one foot. Vision: All infants with critical congenital heart disease are detected before leaving the nursery. Vision Who, What, When, Where, and Why? Congenital Heart Disease Screening Program♥
8
Program Overview
Thank you for your interest in the Congenital Heart Disease Screening Program (CHDSP). We are excited to provide you with the resources that you will need to implement the CHDSP in your newborn nursery. The components of this program have been assembled by Children’s National Medical Center.

Congenital Heart Defects Information for Healthcare Providers | CDC Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources
 Critical CHDs
Coarctation of the aorta
Double outlet right ventricle
Ebstein anomaly
Hypoplastic left heart syndrome
Interrupted aortic arch
Pulmonary atresia
Single ventricle
Tetralogy of Fallot
Total anomalous pulmonary venous return
d-Transposition of the great arteries
Tricuspid artresia
Truncus ateriosus
Other critical CHDs requiring treatment in the first year of life
Other Conditions that are not critical CHDs
Hemoglobinopathy
Hypothermia
Infection, including sepsis
Lung disease (congenital or acquired)
Non-critical congenital heart defect
Persistent pulmonary hypertension
Other hypoxic conditions not otherwise specified
Failed Screens
A screen is considered failed if: Any oxygen saturation measure is <90% (in the initial screen or in repeat screens),
Oxygen saturation is <95% in the right hand and foot on three measures, each separated by one hour, or
A >3% absolute difference exists in oxygen saturation between the right hand and foot on three measures, each separated by one hour. Any infant who fails the screen should have an evaluation for causes of hypoxemia. In most cases this will include an echocardiogram, but if a reversible cause of hypoxemia is identified and appropriately treated, an echocardiogram may not be necessary. The infant’s pediatrician should be notified immediately and the infant might need to be seen by a cardiologist. Passed Screens
Any screening with an oxygen saturation measure that is ≥95% in the right hand or foot with a ≤3% absolute difference between the right hand or foot is considered a passed screen and screening would end. Pulse oximetry screening does not detect all critical CHDs, so it is possible for a baby with a passing screening result to still have a critical CHD or other CHD. Ways to Reduce False Positive Screens
Screen the newborn while he or she is alert. Screen the newborn when he or she is at least 24 hours old. Other Tools or Resources
American Academy of Pediatrics:

A health care provider may ask for more testing (such as an ultrasound of the heart or an echocardiogram) when a low pulse oximetry reading is identified. Who Should be Screened and When Will the Test be Done? According to the Children's National Medical Center, all babies in the newborn nursery who are not already thought to have CHD should be screened. The pulse oximetry test should be performed when a baby is older than 24 hours. What is a Normal Reading? A pulse oximetry reading of 95 to 100 percent is normal in healthy babies. Babies with heart or lung problems may have lower readings. A low reading can be normal in newborns whose lungs and heart are adjusting after birth. Can a Baby with Serious CHD Have a Normal Pulse Oximetry Reading? It is possible that the test will not detect all forms of problems in the baby's heart.

A health care provider may ask for more testing (such as an ultrasound of the heart or an echocardiogram) when a low pulse oximetry reading is identified. Who Should be Screened and When Will the Test be Done? According to the Children's National Medical Center, all babies in the newborn nursery who are not already thought to have CHD should be screened. The pulse oximetry test should be performed when a baby is older than 24 hours. What is a Normal Reading? A pulse oximetry reading of 95 to 100 percent is normal in healthy babies. Babies with heart or lung problems may have lower readings. A low reading can be normal in newborns whose lungs and heart are adjusting after birth. Can a Baby with Serious CHD Have a Normal Pulse Oximetry Reading? It is possible that the test will not detect all forms of problems in the baby's heart.

Critical Congenital Heart Disease | Ohio Department of Health Critical Congenital Heart Disease
Critical Congenital Heart Disease
Facts about Congenital Heart Disease
CCHD Resources
Contact Us
 Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CCHDs. These seven main screening targets are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as the main screening targets and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven disorders listed as the main screening targets. CCHD Resources
Centers for Disease Control & Prevention
http://www.cdc.gov/ncbddd/heartdefects/screening.html
Baby’s First Test
http://www.babysfirsttest.org/newborn-screening/conditions/critical-congenital-heart-disease-cchd
Federal Maternal & Child Health Bureau
http://www.newbornscreening.info/Parents/otherdisorders/CCHD.html
American Academy of Pediatrics
http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/PEHDIC/Pages/Newborn-Screening-for-CCHD.aspx
Contact Us
Naomi Halverson
Critical Congenital Heart Disease Newborn Screening
Ohio Department of Health
246 N. High St.
Columbus, Ohio 43215
Phone: 614-387-1228
Email : Naomi.Halverson@odh.ohio.gov
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Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CCHDs. These seven main screening targets are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as the main screening targets and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven disorders listed as the main screening targets. CCHD Resources
Centers for Disease Control & Prevention
http://www.cdc.gov/ncbddd/heartdefects/screening.html
Baby’s First Test
http://www.babysfirsttest.org/newborn-screening/conditions/critical-congenital-heart-disease-cchd
Federal Maternal & Child Health Bureau
http://www.newbornscreening.info/Parents/otherdisorders/CCHD.html
American Academy of Pediatrics
http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/PEHDIC/Pages/Newborn-Screening-for-CCHD.aspx
Contact Us
Naomi Halverson
Critical Congenital Heart Disease Newborn Screening
Ohio Department of Health
246 N. High St.
Columbus, Ohio 43215
Phone: 614-387-1228
Email : Naomi.Halverson@odh.ohio.gov
Web Content Viewer
Actions
Menu Close
Help
Search
Ohio Department of Health
Home
Who We Are
About Us
Know our
Programs
Health Rules
Laws & Forms
Explore
Data & Stats
Find Local
Health Districts
Media Center
Help Center
Search
Ohio Department of Health
Close
Search in our portal
Submit your search

A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry | American Academy of Pediatrics A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
Abstract
An unanticipated problem was encountered, check back soon and try again
What’s Known on This Subject:
What This Study Adds:
Methods
Identifying True-Positives, False-Positives, True-Negatives, and False-Negatives
Simulation Study
Statistics
Results
Discussion
Strengths
Limitations
Conclusions
Footnotes
References
In this issue
View this article with LENS
Jump to section
Subjects
 1–3 Among infants with CHD, ∼25% have lesions considered to be critical congenital heart disease (CCHD), requiring surgical or catheterization intervention within the first year of life. 1 Although the 1-year survival rate for infants with CCHD has improved over the decades, 4 it remains a leading cause of infant morbidity and mortality. 5 To aid in the early detection of CCHD, screening for CCHD by using pulse oximetry was added to the US Recommended Uniform Screening Panel in 2011 and has been endorsed by multiple professional societies, including the American Academy of Pediatrics (AAP), the American Heart Association, and the American College of Cardiology, to improve early identification of infants with CCHD. 6,7 Recently, CCHD screening has been shown to decrease infant mortality from CCHD in states with mandatory screening policies. 8 CCHD pulse oximetry screening was added to the Georgia newborn screening panel in 2015, 9 although many hospitals in Georgia began using CCHD pulse oximetry screening as early as 2012. 10
Current CCHD screening recommendations involve the use of pulse oximetry to detect levels of hypoxemia in the newborn infant. On the basis of the pulse oximetry values, an algorithm is used to determine if a child has passed or failed screening; however, there is no single algorithm that has been proven to be superior. 6,11 In most states in the United States, screening is performed by using the algorithm endorsed by the AAP ( Fig 1 ), 12 although other states such as New Jersey 13 and Tennessee 14 have adopted modifications of that algorithm. The AAP algorithm is based off of previous work performed in Sweden.

A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry | American Academy of Pediatrics

A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
Abstract
An unanticipated problem was encountered, check back soon and try again
What’s Known on This Subject:
What This Study Adds:
Methods
Identifying True-Positives, False-Positives, True-Negatives, and False-Negatives
Simulation Study
Statistics
Results
Discussion
Strengths
Limitations
Conclusions
Footnotes
References
In this issue
View this article with LENS
Jump to section
Subjects

1–3 Among infants with CHD, ∼25% have lesions considered to be critical congenital heart disease (CCHD), requiring surgical or catheterization intervention within the first year of life. 1 Although the 1-year survival rate for infants with CCHD has improved over the decades, 4 it remains a leading cause of infant morbidity and mortality. 5 To aid in the early detection of CCHD, screening for CCHD by using pulse oximetry was added to the US Recommended Uniform Screening Panel in 2011 and has been endorsed by multiple professional societies, including the American Academy of Pediatrics (AAP), the American Heart Association, and the American College of Cardiology, to improve early identification of infants with CCHD. 6,7 Recently, CCHD screening has been shown to decrease infant mortality from CCHD in states with mandatory screening policies. 8 CCHD pulse oximetry screening was added to the Georgia newborn screening panel in 2015, 9 although many hospitals in Georgia began using CCHD pulse oximetry screening as early as 2012. 10
Current CCHD screening recommendations involve the use of pulse oximetry to detect levels of hypoxemia in the newborn infant. On the basis of the pulse oximetry values, an algorithm is used to determine if a child has passed or failed screening; however, there is no single algorithm that has been proven to be superior. 6,11 In most states in the United States, screening is performed by using the algorithm endorsed by the AAP ( Fig 1 ), 12 although other states such as New Jersey 13 and Tennessee 14 have adopted modifications of that algorithm. The AAP algorithm is based off of previous work performed in Sweden.

Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project - ScienceDirect Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project
1
,
2

Journal of Pediatric Nursing
Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project 1, 2
Highlights
Key words
Background/Significance
Methods
Forming the Multidisciplinary Team
Creation of Evidence-Based Algorithms
Measures
Piloting Practice Changes
Outcomes
Time on Oxygen
Time on Pulse Oximetry
Length of Stay and Patient Charges
Discussion
Conclusion/Implications for Practice
Acknowledgments
References
 •
Children with the protocol-guided care experienced lower overall charges. Nurses', respiratory therapists' (RTs), and physicians' concerns about oxygen weaning practices and pulse oximetry use in healthy children during inpatient admissions prompted this multidisciplinary evidence-based project. A nurse-led inter-professional team found lack of consistent oxygen weaning practices and lack of guidelines for nurses or RTs regarding pulse oximetry use with children admitted for acute respiratory illness. The team created and piloted evidence-based oxygen weaning and pulse oximetry protocols. After a 6 month pilot, children in the pilot had shorter length of stay, time on oxygen, and time on continuous pulse oximetry. Protocols improved patient outcomes and decreased associated charges. Previous article
in issue
Next article
in issue
Key words
Asthma
Bronchiolitis
Pediatric
Protocol
Acute respiratory illness
Evidence-based protocol
Pulse oximetry
Oxygen weaning
PULSE OXIMETRY IS a simple, noninvasive monitoring tool that has been widely used in the acute care setting since the early 1980s. Often called the “fifth vital sign,” pulse oximetry is helpful in determining oxygen necessity in patients who are at risk for being hypoxic, usually before signs of respiratory distress appear ( Mower, Sachs, Nicklin, & Baraff, 1997 ). Oxygen saturation (SpO2) has been found to be a reliable indicator of disease severity in conditions associated with ventilation/perfusion (V/Q) mismatch, such as exacerbations of asthma, acute bronchiolitis, and pneumonia ( Bradley et al., 2011, Callahan, 2008, Fouzas et al.,

Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project - ScienceDirect

Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project
1
,
2

Journal of Pediatric Nursing
Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project 1, 2
Highlights
Key words
Background/Significance
Methods
Forming the Multidisciplinary Team
Creation of Evidence-Based Algorithms
Measures
Piloting Practice Changes
Outcomes
Time on Oxygen
Time on Pulse Oximetry
Length of Stay and Patient Charges
Discussion
Conclusion/Implications for Practice
Acknowledgments
References

•
Children with the protocol-guided care experienced lower overall charges. Nurses', respiratory therapists' (RTs), and physicians' concerns about oxygen weaning practices and pulse oximetry use in healthy children during inpatient admissions prompted this multidisciplinary evidence-based project. A nurse-led inter-professional team found lack of consistent oxygen weaning practices and lack of guidelines for nurses or RTs regarding pulse oximetry use with children admitted for acute respiratory illness. The team created and piloted evidence-based oxygen weaning and pulse oximetry protocols. After a 6 month pilot, children in the pilot had shorter length of stay, time on oxygen, and time on continuous pulse oximetry. Protocols improved patient outcomes and decreased associated charges. Previous article
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Key words
Asthma
Bronchiolitis
Pediatric
Protocol
Acute respiratory illness
Evidence-based protocol
Pulse oximetry
Oxygen weaning
PULSE OXIMETRY IS a simple, noninvasive monitoring tool that has been widely used in the acute care setting since the early 1980s. Often called the “fifth vital sign,” pulse oximetry is helpful in determining oxygen necessity in patients who are at risk for being hypoxic, usually before signs of respiratory distress appear ( Mower, Sachs, Nicklin, & Baraff, 1997 ). Oxygen saturation (SpO2) has been found to be a reliable indicator of disease severity in conditions associated with ventilation/perfusion (V/Q) mismatch, such as exacerbations of asthma, acute bronchiolitis, and pneumonia ( Bradley et al., 2011, Callahan, 2008, Fouzas et al.,

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 Lancet. 2014 Aug 30;384 (9945):747-54. 11. Kemper AR et al. Pediatrics. 2011 Nov;128 (5):e1259-67. RESOURCES
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Masimo - Newborn Care

Newborn Care
Newborn Care
Masimo SET ® Measure-through Motion and Low Perfusion™ Pulse Oximetry
Performance During Motion and Low Perfusion 3
Solutions for Newborn Resuscitation
Improving CCHD Screening with Masimo SET ®
Masimo SET ® Sensors for CCHD Screening
Measurements
Newborn Care Solutions
Radical-7 ®
Rad-97 ® with Noninvasive
Blood Pressure
Root ® Platform
Newborn Sensors
RD SET ® Sensors
Reusable Y-I Sensors
OEM Products
RESOURCES
CCHD Screening with Pulse Oximetry Solutions
Masimo SET
RD SET Sensors
Newborn Sensors
CCHD Screening
Neonatal & Infant Care Solutions

Lancet. 2014 Aug 30;384 (9945):747-54. 11. Kemper AR et al. Pediatrics. 2011 Nov;128 (5):e1259-67. RESOURCES
CCHD Screening with Pulse Oximetry Solutions
Brochure
Masimo SET
Product Information
RD SET Sensors
Brochure
Newborn Sensors
Product Information
CCHD Screening
Instructional Guide
Neonatal & Infant Care Solutions
Product Information
Rad-97 NIBP is not licensed for sale in Canada. Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. See instructions for use for full prescribing information, including indications, contraindications, warnings, and precautions.

Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project - ScienceDirect Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project
1
,
2

Journal of Pediatric Nursing
Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project 1, 2
Highlights
Key words
Background/Significance
Methods
Forming the Multidisciplinary Team
Creation of Evidence-Based Algorithms
Measures
Piloting Practice Changes
Outcomes
Time on Oxygen
Time on Pulse Oximetry
Length of Stay and Patient Charges
Discussion
Conclusion/Implications for Practice
Acknowledgments
References
 No clear guidelines currently exist to provide standardized pulse oximetry and oxygen weaning practice in hospitalized children with acute respiratory illness ( Fouzas et al., 2011 ). Background/Significance
Nurses participating in their hospital Nursing Evidence-Based Practice and Research (NEBPR) Council at a 429 bed free-standing children's hospital in the southwestern United States recognized practice problems related to use of pulse oximetry and oxygen. A staff survey of registered nurses (RNs), respiratory therapists (RTs), and physicians highlighted the following issues: ( 1) lack of consistency in use of pulse oximetry; ( 2) no evidence-based definition of how and when to wean oxygen; and (3) no explicit permission for staff to use pulse oximetry or deliver oxygen to children on inpatient medical units without a physician order. The nurses formed a task force and developed the following question: “ Will oxygen weaning and pulse oximetry protocols for inpatient children with acute respiratory illnesses result in consistent practices as noted by chart audits and decrease: time on oxygen, time on pulse oximetry, length of stay, and charges to patients?”

No clear guidelines currently exist to provide standardized pulse oximetry and oxygen weaning practice in hospitalized children with acute respiratory illness ( Fouzas et al., 2011 ). Background/Significance
Nurses participating in their hospital Nursing Evidence-Based Practice and Research (NEBPR) Council at a 429 bed free-standing children's hospital in the southwestern United States recognized practice problems related to use of pulse oximetry and oxygen. A staff survey of registered nurses (RNs), respiratory therapists (RTs), and physicians highlighted the following issues: ( 1) lack of consistency in use of pulse oximetry; ( 2) no evidence-based definition of how and when to wean oxygen; and (3) no explicit permission for staff to use pulse oximetry or deliver oxygen to children on inpatient medical units without a physician order. The nurses formed a task force and developed the following question: “ Will oxygen weaning and pulse oximetry protocols for inpatient children with acute respiratory illnesses result in consistent practices as noted by chart audits and decrease: time on oxygen, time on pulse oximetry, length of stay, and charges to patients?”

Top 5 Best Pulse Oximeter | 2020 Reviews | ParentsNeed Top 5 Best Pulse Oximeter | 2021 Reviews
Top 5 Best Pulse Oximeter | 2021 Reviews
Top 5 Best Pulse Oximeter | 2021 Reviews
Quick Comparison Table
Quick Comparison Table
History of Birth | HypnoBirthing Cloud | www.hypnobirthing.cloud
Santamedical Generation 2 SM-165 Fingertip Pulse Oximeter
Acc U Rate Children Digital Finger Pulse Oximeter
Concord Health Supply Fingertip Pulse Oximeter
Innovo CMS 50F PLUS OLED Wrist Color Pulse Oximeter
Acc U Rate Pro Series CMS 500D Deluxe Pulse Oximeter
 It also comes with a cute animal theme specially designed for children. The display is very simple and very bright. It is simplified along with the cute animal theme. In a minute, you can already check your pulse rate and your child's as well. This pediatric fingertip pulse oximeter can be used for kids from 2 years old and above. However, if you have a bigger baby who is younger than two, then it can also be measured using this oximeter. We love that this pulse oximeter uses OLED screen display. It can also display the readings in any direction so no worries about you having to turn the entire pulse oximeter just to read the display. The display has a plethysmograph waveform which makes it easier for us to determine the strength of you and your child's heartbeat. It's like a wave that literally shows what your heartbeat would look like as an image.

Top 5 Best Pulse Oximeter | 2020 Reviews | ParentsNeed

Top 5 Best Pulse Oximeter | 2021 Reviews
Top 5 Best Pulse Oximeter | 2021 Reviews
Top 5 Best Pulse Oximeter | 2021 Reviews
Quick Comparison Table
Quick Comparison Table
History of Birth | HypnoBirthing Cloud | www.hypnobirthing.cloud
Santamedical Generation 2 SM-165 Fingertip Pulse Oximeter
Acc U Rate Children Digital Finger Pulse Oximeter
Concord Health Supply Fingertip Pulse Oximeter
Innovo CMS 50F PLUS OLED Wrist Color Pulse Oximeter
Acc U Rate Pro Series CMS 500D Deluxe Pulse Oximeter

It also comes with a cute animal theme specially designed for children. The display is very simple and very bright. It is simplified along with the cute animal theme. In a minute, you can already check your pulse rate and your child's as well. This pediatric fingertip pulse oximeter can be used for kids from 2 years old and above. However, if you have a bigger baby who is younger than two, then it can also be measured using this oximeter. We love that this pulse oximeter uses OLED screen display. It can also display the readings in any direction so no worries about you having to turn the entire pulse oximeter just to read the display. The display has a plethysmograph waveform which makes it easier for us to determine the strength of you and your child's heartbeat. It's like a wave that literally shows what your heartbeat would look like as an image.

A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry | American Academy of Pediatrics A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
Abstract
An unanticipated problem was encountered, check back soon and try again
What’s Known on This Subject:
What This Study Adds:
Methods
Identifying True-Positives, False-Positives, True-Negatives, and False-Negatives
Simulation Study
Statistics
Results
Discussion
Strengths
Limitations
Conclusions
Footnotes
References
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 A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry | American Academy of Pediatrics
Article
A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
Christina L. Diller, Michael S. Kelleman, Kenneth G. Kupke, Sharon C. Quary, Lazaros K. Kochilas and Matthew E. Oster
Pediatrics May 2018, 141 (5) e20174065; DOI: https://doi.org/10.1542/peds.2017-4065
Christina L. Diller
a Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia; b Children’s Healthcare of Atlanta, Atlanta, Georgia; and
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Michael S. Kelleman
a Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia; Find this author on Google Scholar
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Kenneth G. Kupke
c Northside Hospital, Atlanta, Georgia
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Sharon C. Quary
c Northside Hospital, Atlanta, Georgia
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Lazaros K. Kochilas
a Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia; b Children’s Healthcare of Atlanta, Atlanta, Georgia; and
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Matthew E. Oster
a Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia; b Children’s Healthcare of Atlanta, Atlanta, Georgia; and
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PEDIATRIC PULSE OXIMETER
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PEDIATRIC PULSE OXIMETER INFORMATION
Pediatric pulse oximeters are designed to be able read oxygen (SpO2 %) and heart rate from primarily the toes and/or fingers of neonates (under 8lbs.), infants (5 to 45 lbs.), and children (under 75 lbs.). The most common type of pediatric pulse oximeters are hand held pulse oximeters with a sensor that is designed specifically for the weight/size of the child. Hand held oximeters are preferred because you can use different sensors depending on the size of the person. Hand held oximeters can also take readings from the forehead and ear with the appropriate sensor. Ears and/or foreheads can be used as a location to take a reading but it is not recommended for children under 50 lbs. The Nonin Onyx Vantage 9590 finger pulse oximeter has been cleared by the FDA for accuracy to be used to take readings from a toe. The Nonin 9590 can be used on fingers/toes as thin as 8 mm (0.3 inches).

PEDIATRIC PULSE OXIMETER

List Price: $565.00
List Price: $225.00
List Price: $395.00
List Price: $799.00
List Price: $1,299.00
List Price: $699.00
List Price: $595.00
List Price: $795.00
List Price: $499.00

PEDIATRIC PULSE OXIMETER
You are here: Home > PULSE OXIMETERS BY FUNCTION > PEDIATRIC OXIMETERS
Find by Pricing
Below 360 (3)
360 to 539.99 (2)
540 and Above (4)
Find by Brand
bci (1)

PEDIATRIC PULSE OXIMETER INFORMATION
Pediatric pulse oximeters are designed to be able read oxygen (SpO2 %) and heart rate from primarily the toes and/or fingers of neonates (under 8lbs.), infants (5 to 45 lbs.), and children (under 75 lbs.). The most common type of pediatric pulse oximeters are hand held pulse oximeters with a sensor that is designed specifically for the weight/size of the child. Hand held oximeters are preferred because you can use different sensors depending on the size of the person. Hand held oximeters can also take readings from the forehead and ear with the appropriate sensor. Ears and/or foreheads can be used as a location to take a reading but it is not recommended for children under 50 lbs. The Nonin Onyx Vantage 9590 finger pulse oximeter has been cleared by the FDA for accuracy to be used to take readings from a toe. The Nonin 9590 can be used on fingers/toes as thin as 8 mm (0.3 inches).

A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry | American Academy of Pediatrics A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
Abstract
An unanticipated problem was encountered, check back soon and try again
What’s Known on This Subject:
What This Study Adds:
Methods
Identifying True-Positives, False-Positives, True-Negatives, and False-Negatives
Simulation Study
Statistics
Results
Discussion
Strengths
Limitations
Conclusions
Footnotes
References
In this issue
View this article with LENS
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 No single algorithm has proven to be superior. Infants with failed CCHD pulse oximetry screenings have been found to have non-CCHD disease. What This Study Adds: Modifying the algorithm for CCHD screening such that there is only 1 repeat screening instead of 2 could improve detection of hypoxemic disease in the newborn with minimal impact on the CCHD screening false-positive rate. Congenital heart disease (CHD) occurs in ∼8 out of every 1000 live births each year, affecting ∼40 000 infants per year in the United States. 1–3 Among infants with CHD, ∼25% have lesions considered to be critical congenital heart disease (CCHD), requiring surgical or catheterization intervention within the first year of life. 1 Although the 1-year survival rate for infants with CCHD has improved over the decades, 4 it remains a leading cause of infant morbidity and mortality. 5 To aid in the early detection of CCHD, screening for CCHD by using pulse oximetry was added to the US Recommended Uniform Screening Panel in 2011 and has been endorsed by multiple professional societies, including the American Academy of Pediatrics (AAP), the American Heart Association, and the American College of Cardiology, to improve early identification of infants with CCHD. 6,7 Recently, CCHD screening has been shown to decrease infant mortality from CCHD in states with mandatory screening policies. 8 CCHD pulse oximetry screening was added to the Georgia newborn screening panel in 2015, 9 although many hospitals in Georgia began using CCHD pulse oximetry screening as early as 2012.

No single algorithm has proven to be superior. Infants with failed CCHD pulse oximetry screenings have been found to have non-CCHD disease. What This Study Adds: Modifying the algorithm for CCHD screening such that there is only 1 repeat screening instead of 2 could improve detection of hypoxemic disease in the newborn with minimal impact on the CCHD screening false-positive rate. Congenital heart disease (CHD) occurs in ∼8 out of every 1000 live births each year, affecting ∼40 000 infants per year in the United States. 1–3 Among infants with CHD, ∼25% have lesions considered to be critical congenital heart disease (CCHD), requiring surgical or catheterization intervention within the first year of life. 1 Although the 1-year survival rate for infants with CCHD has improved over the decades, 4 it remains a leading cause of infant morbidity and mortality. 5 To aid in the early detection of CCHD, screening for CCHD by using pulse oximetry was added to the US Recommended Uniform Screening Panel in 2011 and has been endorsed by multiple professional societies, including the American Academy of Pediatrics (AAP), the American Heart Association, and the American College of Cardiology, to improve early identification of infants with CCHD. 6,7 Recently, CCHD screening has been shown to decrease infant mortality from CCHD in states with mandatory screening policies. 8 CCHD pulse oximetry screening was added to the Georgia newborn screening panel in 2015, 9 although many hospitals in Georgia began using CCHD pulse oximetry screening as early as 2012.

Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project - ScienceDirect Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project
1
,
2

Journal of Pediatric Nursing
Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project 1, 2
Highlights
Key words
Background/Significance
Methods
Forming the Multidisciplinary Team
Creation of Evidence-Based Algorithms
Measures
Piloting Practice Changes
Outcomes
Time on Oxygen
Time on Pulse Oximetry
Length of Stay and Patient Charges
Discussion
Conclusion/Implications for Practice
Acknowledgments
References
 2011, Khemani et al., 2012, Mower et al., 1997 ). Despite its popularity and usefulness, pulse oximetry does have several limitations, including motion artifacts, poor perfusion at the site of measurement, irregular rhythms, ambient light or electromagnetic interference, and time lag in detecting hypoxic events. In addition, poor performance can occur with certain skin pigmentation, nail polish, probe positioning, venous pulsations, intravenous dyes, calibration assumptions, and presence of abnormal hemoglobin molecules ( Fouzas et al., 2011 ). Successful use of continuous pulse oximetry is also hindered by staff competency and understanding of the above limitations, frustration with false alarms, and failure to follow manufacturer guidelines regarding proper oximetry use ( Mininni, Marino, Kohler, & Stephan, 2009 ). Researchers have hypothesized that the increased use of pulse oximetry since the 1980s has been associated with increased admissions and length of stay because of unclear guidelines about safe SpO2 levels in children discharged from the hospital, especially in the bronchiolitis population ( Shay et al., 1999, Zentz, 2011 ). Approximately 149,000 children were hospitalized with bronchiolitis in the U.S. in 2002 ( Pelletier, Mansbach, & Camargo, 2006 ).

2011, Khemani et al., 2012, Mower et al., 1997 ). Despite its popularity and usefulness, pulse oximetry does have several limitations, including motion artifacts, poor perfusion at the site of measurement, irregular rhythms, ambient light or electromagnetic interference, and time lag in detecting hypoxic events. In addition, poor performance can occur with certain skin pigmentation, nail polish, probe positioning, venous pulsations, intravenous dyes, calibration assumptions, and presence of abnormal hemoglobin molecules ( Fouzas et al., 2011 ). Successful use of continuous pulse oximetry is also hindered by staff competency and understanding of the above limitations, frustration with false alarms, and failure to follow manufacturer guidelines regarding proper oximetry use ( Mininni, Marino, Kohler, & Stephan, 2009 ). Researchers have hypothesized that the increased use of pulse oximetry since the 1980s has been associated with increased admissions and length of stay because of unclear guidelines about safe SpO2 levels in children discharged from the hospital, especially in the bronchiolitis population ( Shay et al., 1999, Zentz, 2011 ). Approximately 149,000 children were hospitalized with bronchiolitis in the U.S. in 2002 ( Pelletier, Mansbach, & Camargo, 2006 ).

 false positives and negatives; and main costs are incurred by follow-up testing to the pulse oximetry screening. COSTS
Many hospitals already have pulse oximetry machines and the only additional cost is for use of the probe which is about $1 per reusable probe, or $7 to $8 for a single-use probe, according to the Children's National Medical Center. New Jersey (see below) estimates a cost of $10 per screening. A screening may be repeated if test results show the blood is lacking oxygen, and then more expensive ultrasounds or echocardiograms would be performed. Nursing time required to do pulse oximetry testing on newborns averages about three minutes per baby. Some critics of mandatory pulse oximetry screening raise the issue of the added cost of echocardiography in false-positive cases. FEDERAL RECOMMENDATIONS
Requiring pulse oximetry screening for newborns has been a state level issue for several years with proposals to have it included with other mandatory screenings for newborns. In October 2010, the Department HHS Advisory Committee on Heritable Diseases in Newborns and Children made a recommendation to add CHD to the uniform screening panel. It stated that “although there are recognizable evidence gaps, there are compelling reasons for recommending newborns for CHD.”

false positives and negatives; and main costs are incurred by follow-up testing to the pulse oximetry screening. COSTS
Many hospitals already have pulse oximetry machines and the only additional cost is for use of the probe which is about $1 per reusable probe, or $7 to $8 for a single-use probe, according to the Children's National Medical Center. New Jersey (see below) estimates a cost of $10 per screening. A screening may be repeated if test results show the blood is lacking oxygen, and then more expensive ultrasounds or echocardiograms would be performed. Nursing time required to do pulse oximetry testing on newborns averages about three minutes per baby. Some critics of mandatory pulse oximetry screening raise the issue of the added cost of echocardiography in false-positive cases. FEDERAL RECOMMENDATIONS
Requiring pulse oximetry screening for newborns has been a state level issue for several years with proposals to have it included with other mandatory screenings for newborns. In October 2010, the Department HHS Advisory Committee on Heritable Diseases in Newborns and Children made a recommendation to add CHD to the uniform screening panel. It stated that “although there are recognizable evidence gaps, there are compelling reasons for recommending newborns for CHD.”

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 Critical CHD, however, can bring a significant risk of morbidity and mortality if not diagnosed in a timely manner. Failing to detect critical CHD while in the newborn nursery may lead to critical events, such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Fortunately, a routine test exists that can help us identify most infants with critical CHD. What is the Pulse Oximetry Test? Pulse oximetry is a simple, non-invasive and painless test that is used to measure the percent of oxygen saturation of hemoglobin in the arterial blood and the pulse rate. The pulse-oximetry test was invented in the 1970s and is now widely used and accepted in clinical care. In fact, it is often considered a vital sign. Traditionally, pulse oximetry has been used to monitor an individual’s oxygen saturation during acute and chronic illness, as well as during procedures requiring general anesthesia or sedation. Why is Pulse Oximetry Used to Screen for CHD?

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Critical CHD, however, can bring a significant risk of morbidity and mortality if not diagnosed in a timely manner. Failing to detect critical CHD while in the newborn nursery may lead to critical events, such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Fortunately, a routine test exists that can help us identify most infants with critical CHD. What is the Pulse Oximetry Test? Pulse oximetry is a simple, non-invasive and painless test that is used to measure the percent of oxygen saturation of hemoglobin in the arterial blood and the pulse rate. The pulse-oximetry test was invented in the 1970s and is now widely used and accepted in clinical care. In fact, it is often considered a vital sign. Traditionally, pulse oximetry has been used to monitor an individual’s oxygen saturation during acute and chronic illness, as well as during procedures requiring general anesthesia or sedation. Why is Pulse Oximetry Used to Screen for CHD?

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease - HealthyChildren.org Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
What is pulse oximetry?
Fetal ultrasounds of the heart do not detect all types of heart defects.
How is this screening is done?
What happens a baby fails the pulse oximetry screening?
If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?
Even if a baby passes the pulse oximetry screening, parents should watch:
Additional Information & Resources:
 How is this screening is done? A small soft sensor is wrapped around the baby's right hand and one foot. The sensor is hooked up to a monitor for about 5 minutes and measures the oxygen level in the blood and the heart rate. It is fast, easy, and does not hurt. Pulse oximetry screening is done after 24 hours after birth to allow the baby's heart and lungs to fully adjust to life outside his or her mother. After the screening is completed, the doctor or nurse will go over the reading with the baby's parents. What happens a baby fails the pulse oximetry screening? If the screening test suggests a problem, additional testing to evaluate for CHD or for other potential causes of low oxygen will be necessary before the baby will be discharged from the hospital. Testing may include a chest radiography and bloodwork. A thorough ultrasound of the baby's heart called an echocardiogram will be performed and read by a pediatric cardiologist.

Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
Newborn Pulse Oximetry Screening to Detect Critical Congenital Heart Disease
What is pulse oximetry?
Fetal ultrasounds of the heart do not detect all types of heart defects.
How is this screening is done?
What happens a baby fails the pulse oximetry screening?
If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?
Even if a baby passes the pulse oximetry screening, parents should watch:
Additional Information & Resources:

How is this screening is done? A small soft sensor is wrapped around the baby's right hand and one foot. The sensor is hooked up to a monitor for about 5 minutes and measures the oxygen level in the blood and the heart rate. It is fast, easy, and does not hurt. Pulse oximetry screening is done after 24 hours after birth to allow the baby's heart and lungs to fully adjust to life outside his or her mother. After the screening is completed, the doctor or nurse will go over the reading with the baby's parents. What happens a baby fails the pulse oximetry screening? If the screening test suggests a problem, additional testing to evaluate for CHD or for other potential causes of low oxygen will be necessary before the baby will be discharged from the hospital. Testing may include a chest radiography and bloodwork. A thorough ultrasound of the baby's heart called an echocardiogram will be performed and read by a pediatric cardiologist.

Critical Congenital Heart Defects | CDC Critical Congenital Heart Defects
Critical Congenital Heart Defects
What are Critical Congenital Heart Defects (Critical CHDs)?
Some Specific Critical CHDs
Importance of Newborn Screening for Critical CHDs
How Newborn Screening for Critical CHDs is Done
Possible Physical Symptoms of Critical CHDs
Timing of Critical CHD Screening
Pulse Oximetry Screening Results
Pass
Fail
References
 Timely care may prevent disability or death early in life. How Newborn Screening for Critical CHDs is Done
Newborn screening for critical CHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood can be a sign of a critical CHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby’s skin. The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a critical CHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Possible Physical Symptoms of Critical CHDs
Problems breathing
Pounding heart
Weak pulse
Very pale or blue skin color
Poor feeding
Very sleepy
Timing of Critical CHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CHDs.

Critical Congenital Heart Defects | CDC

Critical Congenital Heart Defects
Critical Congenital Heart Defects
What are Critical Congenital Heart Defects (Critical CHDs)?
Some Specific Critical CHDs
Importance of Newborn Screening for Critical CHDs
How Newborn Screening for Critical CHDs is Done
Possible Physical Symptoms of Critical CHDs
Timing of Critical CHD Screening
Pulse Oximetry Screening Results
Pass
Fail
References

Timely care may prevent disability or death early in life. How Newborn Screening for Critical CHDs is Done
Newborn screening for critical CHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood can be a sign of a critical CHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby’s skin. The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a critical CHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Possible Physical Symptoms of Critical CHDs
Problems breathing
Pounding heart
Weak pulse
Very pale or blue skin color
Poor feeding
Very sleepy
Timing of Critical CHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CHDs.

Congenital Heart Defects Information for Healthcare Providers | CDC Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources
 Critical Congenital Heart Defect (CCHD) Screening Resource for Primary Care Providers
external icon
This online resource was developed by doctors for doctors, to help primary care providers navigate the implementation process and provide effective, long-term medical homes for babies with critical CHDs. American Academy of Pediatrics: Endorsement of Health and Human Services Recommendation for Pulse Oximetry Screening for Critical Congenital Heart Disease [ Read article
pdf icon
[653 KB / 5 pages] ]
Children’s National Medical Center’s Congenital Heart Disease Screening Program has created videos
external icon
about critical CHD screening for parents and healthcare professionals. Congenital Heart Public Health Consortium
external icon
(CHPHC) The CHPHC is a group of organizations uniting resources and efforts in public health activities to prevent congenital heart defects and improve outcomes for affected children and adults. Their website provides resources for families and providers on heart defects and screening. Kemper AR, Mahle WT, Martin GR, Cooley WC, Kumar P, Morrow WR, Kelm K, Pearson GD, Glidewell J, Grosse SD, Lloyd-Puryear M, Howell RR. Strategies for implementing screening for critical congenital heart disease. Pediatrics. 2011; 128:

Congenital Heart Defects Information for Healthcare Providers
Congenital Heart Defects Information for Healthcare Providers
Critical CHD Screening Methods
Critical CHDs
Other Conditions that are not critical CHDs
Failed Screens
Passed Screens
Ways to Reduce False Positive Screens
Other Tools or Resources

Critical Congenital Heart Defect (CCHD) Screening Resource for Primary Care Providers
external icon
This online resource was developed by doctors for doctors, to help primary care providers navigate the implementation process and provide effective, long-term medical homes for babies with critical CHDs. American Academy of Pediatrics: Endorsement of Health and Human Services Recommendation for Pulse Oximetry Screening for Critical Congenital Heart Disease [ Read article
pdf icon
[653 KB / 5 pages] ]
Children’s National Medical Center’s Congenital Heart Disease Screening Program has created videos
external icon
about critical CHD screening for parents and healthcare professionals. Congenital Heart Public Health Consortium
external icon
(CHPHC) The CHPHC is a group of organizations uniting resources and efforts in public health activities to prevent congenital heart defects and improve outcomes for affected children and adults. Their website provides resources for families and providers on heart defects and screening. Kemper AR, Mahle WT, Martin GR, Cooley WC, Kumar P, Morrow WR, Kelm K, Pearson GD, Glidewell J, Grosse SD, Lloyd-Puryear M, Howell RR. Strategies for implementing screening for critical congenital heart disease. Pediatrics. 2011; 128:

Amazon.com: Children Digital Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor with Adorable Animal Theme (not for Newborn/Infant): Health & Personal Care
Other Sellers on Amazon
Children Digital Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor with Adorable Animal Theme (not for Newborn/Infant)
Frequently bought together
Special offers and product promotions
From the manufacturer
Zacurate Children Pulse Oximeter
Quick Look at Features :
Features of the Pulse Oximeter
Plethysmograph Waveform
Multi-Directional Display
Portable and Easy to Carry
Adjustable OLED Brightness
How Does the Plethysmograph Help?
Frequently Asked Questions
Product description
Product details
Product guides and documents
Important information
Legal Disclaimer
Compare with similar items
Customer Questions & Answers
Top reviews from the United States
4.0 out of 5 stars
RN review
5.0 out of 5 stars
Every parent should own one!
4.0 out of 5 stars
If you find this comment useful please press like!!
5.0 out of 5 stars
After having a beautiful preemie boy (2lbs8oz)we were a bit anxious brining him ...
5.0 out of 5 stars
It work on older kids and adults but didn't work on small children....
5.0 out of 5 stars
Works for 9 mo old
5.0 out of 5 stars
Great product, good quality
What other items do customers buy after viewing this item?
 Frequently Asked Questions
Q: What is the pulse rate range the children pulse oximeter can register? A: The digital pulse oximeter is able to measure pulse rate between 30 and 235 beats per minute (bpm). Frequently Asked Questions
Q: Does it fit an adult finger? A: The pulse oximeter is specifically made for children but can also be used by teens and adults with small fingers. 500BL Pulse Oximeter
Pro Series 500DL Pulse Oximeter
500C Elite Pulse Oximeter
Premium Pulse Oximeter
Children Digital Pulse Oximeter
Maximum SpO2 Displayed
99%
100%
100%
100%
100%
Infrared Shield
✓
✓
✓
✓
✓
OLED

✓
✓

Battery Life
30hr
40hr
30hr
30hr
30hr
Plethysmograph

✓
✓
✓
Multi-Directional Display

✓
✓
✓
Sound and Alarm Function

✓

Accuracy deviation under lab conditions
+/- 2%
+/- 2%
+/- 2%
+/- 1%
+/- 2%
Recommended Finger Size
Adult
Adult
Adult
Adult
Child
Recommended Age
>12 Years Old
>12 Years Old
>12 Years Old
>12 Years Old
>2 , <12
Product description
3-steps to get started: 1.

Amazon.com: Children Digital Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor with Adorable Animal Theme (not for Newborn/Infant): Health & Personal Care

Other Sellers on Amazon
Children Digital Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor with Adorable Animal Theme (not for Newborn/Infant)
Frequently bought together
Special offers and product promotions
From the manufacturer
Zacurate Children Pulse Oximeter
Quick Look at Features :
Features of the Pulse Oximeter
Plethysmograph Waveform
Multi-Directional Display
Portable and Easy to Carry
Adjustable OLED Brightness
How Does the Plethysmograph Help?
Frequently Asked Questions
Product description
Product details
Product guides and documents
Important information
Legal Disclaimer
Compare with similar items
Customer Questions & Answers
Top reviews from the United States
4.0 out of 5 stars
RN review
5.0 out of 5 stars
Every parent should own one!
4.0 out of 5 stars
If you find this comment useful please press like!!
5.0 out of 5 stars
After having a beautiful preemie boy (2lbs8oz)we were a bit anxious brining him ...
5.0 out of 5 stars
It work on older kids and adults but didn't work on small children....
5.0 out of 5 stars
Works for 9 mo old
5.0 out of 5 stars
Great product, good quality
What other items do customers buy after viewing this item?

Frequently Asked Questions
Q: What is the pulse rate range the children pulse oximeter can register? A: The digital pulse oximeter is able to measure pulse rate between 30 and 235 beats per minute (bpm). Frequently Asked Questions
Q: Does it fit an adult finger? A: The pulse oximeter is specifically made for children but can also be used by teens and adults with small fingers. 500BL Pulse Oximeter
Pro Series 500DL Pulse Oximeter
500C Elite Pulse Oximeter
Premium Pulse Oximeter
Children Digital Pulse Oximeter
Maximum SpO2 Displayed
99%
100%
100%
100%
100%
Infrared Shield
✓
✓
✓
✓
✓
OLED

✓
✓

Battery Life
30hr
40hr
30hr
30hr
30hr
Plethysmograph

✓
✓
✓
Multi-Directional Display

✓
✓
✓
Sound and Alarm Function

✓

Accuracy deviation under lab conditions
+/- 2%
+/- 2%
+/- 2%
+/- 1%
+/- 2%
Recommended Finger Size
Adult
Adult
Adult
Adult
Child
Recommended Age
>12 Years Old
>12 Years Old
>12 Years Old
>12 Years Old
>2 , <12
Product description
3-steps to get started: 1.

Pulse Oximetry Pulse Oximetry
Pulse Oximetry
Contact Us
 If early discharge is planned, screening should occur as late as possible. Where Should Screening Be Performed? The pulse-oximetry test should be performed on the right hand and one foot. What is a Normal Pulse Oximetry Reading for Infants? A reading of 95 to 100 percent is normal in healthy infants. Infants with heart or lung problems may have lower readings. A low pulse-oximetry reading can also be present in newborns whose circulation is adjusting to life outside of the womb. Contact Us
The Heart Center
Nationwide Children's Hospital
700 Children's Drive
Columbus, OH 43205
Call us at: (614) 722-2530
Request a Second Opinion

Pulse Oximetry

If early discharge is planned, screening should occur as late as possible. Where Should Screening Be Performed? The pulse-oximetry test should be performed on the right hand and one foot. What is a Normal Pulse Oximetry Reading for Infants? A reading of 95 to 100 percent is normal in healthy infants. Infants with heart or lung problems may have lower readings. A low pulse-oximetry reading can also be present in newborns whose circulation is adjusting to life outside of the womb. Contact Us
The Heart Center
Nationwide Children's Hospital
700 Children's Drive
Columbus, OH 43205
Call us at: (614) 722-2530
Request a Second Opinion

 Screening for Critical Congenital Heart Defects
Screening

for

Critical

Congenital

Heart

Defects

Understanding

Critical

CHDs

The

Importance

of

Screening

for

Critical

CHDs

National

Center

on

Birth

Defects

and

Developmental

Disabilities

CDC’s

Activities

for

Critical

CHDs

Moving

Forward

National

Center

on

Birth

Defects

and

Developmental

Disabilities

 Typically,

critical

CHDs

lead

to

low

levels

of

oxygen

in

a

newborn

and

may

be

identified

using

pulse

oximetry

screening

at

least

24

hours

after

birth. Once

identified,

babies

with

a

critical

CHD

can

be

seen

by

heart

doctors

(cardiologists)

and

can

receive

specialized

care

and

treatment

that

could

prevent

death

or

disability

early

in

life. The

Importance

of

Screening

for

Critical

CHDs

Newborn

screening

for

critical

CHDs

using

pulse

oximetry

is

a

tool

that

works

with

prenatal

diagnosis

and

physical

exams

after

birth

to

improve

detection

of

critical

CHDs. Pulse

oximetry

screening

does

not

replace

a

complete

history

and

physical

examination,

which

sometimes

can

detect

a

critical

CHD

before

oxygen

levels

in

the

blood

become

low. CDC

estimates

that,

each

year

in

the

United

States,

an

additional

875

newborns

with

a

critical

CHD

could

be

identified

at

birth

hospitals

by

screening,

before

they

show

signs

of

having

a

critical

CHD. If

doctors

can

confirm

that

a

baby

has

a

critical

CHD,

the

baby

will

receive

needed

care

in

a

timely

manner. Researchers

have

found

newborn

screening

for

critical

CHDs

to

be

cost

effective,

meaning

that

the

health

benefits

of

screening

outweigh

its

costs. Pulse

oximetry

screening

detects

low

blood

oxygen

levels. Examples

of

other

conditions

that

may

lead

to

low

blood

oxygen

levels

are

infection

and

pneumonia. A

baby

with

these

conditions

may

also

be

identified

through

pulse

oximetry

screening

and

receive

needed

care

in

a

timely

manner.

Screening for Critical Congenital Heart Defects
Screening

for

Critical

Congenital

Heart

Defects

Understanding

Critical

CHDs

The

Importance

of

Screening

for

Critical

CHDs

National

Center

on

Birth

Defects

and

Developmental

Disabilities

CDC’s

Activities

for

Critical

CHDs

Moving

Forward

National

Center

on

Birth

Defects

and

Developmental

Disabilities

Typically,

critical

CHDs

lead

to

low

levels

of

oxygen

in

a

newborn

and

may

be

identified

using

pulse

oximetry

screening

at

least

24

hours

after

birth. Once

identified,

babies

with

a

critical

CHD

can

be

seen

by

heart

doctors

(cardiologists)

and

can

receive

specialized

care

and

treatment

that

could

prevent

death

or

disability

early

in

life. The

Importance

of

Screening

for

Critical

CHDs

Newborn

screening

for

critical

CHDs

using

pulse

oximetry

is

a

tool

that

works

with

prenatal

diagnosis

and

physical

exams

after

birth

to

improve

detection

of

critical

CHDs. Pulse

oximetry

screening

does

not

replace

a

complete

history

and

physical

examination,

which

sometimes

can

detect

a

critical

CHD

before

oxygen

levels

in

the

blood

become

low. CDC

estimates

that,

each

year

in

the

United

States,

an

additional

875

newborns

with

a

critical

CHD

could

be

identified

at

birth

hospitals

by

screening,

before

they

show

signs

of

having

a

critical

CHD. If

doctors

can

confirm

that

a

baby

has

a

critical

CHD,

the

baby

will

receive

needed

care

in

a

timely

manner. Researchers

have

found

newborn

screening

for

critical

CHDs

to

be

cost

effective,

meaning

that

the

health

benefits

of

screening

outweigh

its

costs. Pulse

oximetry

screening

detects

low

blood

oxygen

levels. Examples

of

other

conditions

that

may

lead

to

low

blood

oxygen

levels

are

infection

and

pneumonia. A

baby

with

these

conditions

may

also

be

identified

through

pulse

oximetry

screening

and

receive

needed

care

in

a

timely

manner.

A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry | American Academy of Pediatrics A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
A Modified Algorithm for Critical Congenital Heart Disease Screening Using Pulse Oximetry
Abstract
An unanticipated problem was encountered, check back soon and try again
What’s Known on This Subject:
What This Study Adds:
Methods
Identifying True-Positives, False-Positives, True-Negatives, and False-Negatives
Simulation Study
Statistics
Results
Discussion
Strengths
Limitations
Conclusions
Footnotes
References
In this issue
View this article with LENS
Jump to section
Subjects
 By using the current AAP algorithm, 77 114 (99.96%) infants passed screening, 18 infants failed for an initial saturation of <90%, and 16 failed after not attaining a passing pulse oximetry level after 3 tests. There was 1 true-positive (total anomalous pulmonary venous return), 33 false-positives, and 6 false-negatives, yielding an overall specificity of 99.96%, a sensitivity of 14.3%, and a false-positive rate of 0.043%. Among false-positives, 10 (31.3%) had significant non-CCHD disease. Simulating the modified algorithm, sensitivity remained at 14.3%, and the false-positive rate increased to 0.054%. CONCLUSIONS: Although CCHD screening in a tertiary care birth hospital may not detect many new cases of CCHD, it can detect other important diseases in newborns. Modifying the screening algorithm to 1 repeat pulse oximetry test instead of 2 may detect additional infants with significant disease without a substantial increase in the false-positive rate. Abbreviations: AAP —
American Academy of Pediatrics
ASD —
atrial septal defect
CAVC —
complete atrioventricular canal
CCHD —
critical congenital heart disease
CHD —
congenital heart disease
CHOA —
Children’s Healthcare of Atlanta
HLHS —
hypoplastic left heart syndrome
TAPVR —
total anomalous pulmonary venous return
TOF —
tetralogy of Fallot
VSD —
ventricular septal defect
What’s Known on This Subject: Current critical congenital heart disease (CCHD) screening recommendations involve the use of pulse oximetry to detect hypoxemia in newborns.

By using the current AAP algorithm, 77 114 (99.96%) infants passed screening, 18 infants failed for an initial saturation of <90%, and 16 failed after not attaining a passing pulse oximetry level after 3 tests. There was 1 true-positive (total anomalous pulmonary venous return), 33 false-positives, and 6 false-negatives, yielding an overall specificity of 99.96%, a sensitivity of 14.3%, and a false-positive rate of 0.043%. Among false-positives, 10 (31.3%) had significant non-CCHD disease. Simulating the modified algorithm, sensitivity remained at 14.3%, and the false-positive rate increased to 0.054%. CONCLUSIONS: Although CCHD screening in a tertiary care birth hospital may not detect many new cases of CCHD, it can detect other important diseases in newborns. Modifying the screening algorithm to 1 repeat pulse oximetry test instead of 2 may detect additional infants with significant disease without a substantial increase in the false-positive rate. Abbreviations: AAP —
American Academy of Pediatrics
ASD —
atrial septal defect
CAVC —
complete atrioventricular canal
CCHD —
critical congenital heart disease
CHD —
congenital heart disease
CHOA —
Children’s Healthcare of Atlanta
HLHS —
hypoplastic left heart syndrome
TAPVR —
total anomalous pulmonary venous return
TOF —
tetralogy of Fallot
VSD —
ventricular septal defect
What’s Known on This Subject: Current critical congenital heart disease (CCHD) screening recommendations involve the use of pulse oximetry to detect hypoxemia in newborns.

Newborn Screening for CCHD Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Newborn Screening: Critical Congenital Heart Defects
Answers and Resources for Primary Care Pediatricians
Frequently Asked Questions
Topic 1: Rationale for CCHD Screening
Topic 2: Implementation of CCHD
Topic 3: CCHD Screening Data Collection and Management
Topic 4: Screening in Special Settings
Ask a CCHD Implementation question
Resources
State Implementation
References
Related AAP Policy Statements
 Because early infancy intervention is essential for babies with CCHD, adding CCHD to newborn screening is an important strategy to assure that all newborns are screened. Some states now mandate that all newborns be screened by pulse oximetry for CCHD as part of newborn screening. The role of state health departments in supporting CCHD screening adoption and monitoring of screening rates and outcomes varies. Unlike other current newborn screening tests, the health care team should assure diagnostic, and when necessary, treatment services are provided to those babies with a failed CCHD screen prior to discharge home. It is also important for health care providers in states that have adopted CCHD newborn screening to be aware of the specific requirements and recommendations for screening and the reporting of results. The AAP recommends that all newborns be screened for CCHD, regardless of whether they live in a state that includes CCHD screening within their newborn screening program.
If an asymptomatic infant fails their pulse-oximetry screening, what is the likelihood that CCHD or some other serious disease is present? In the Swedish study on which the recommended pulse-oximetry screening protocol is based, 25% of babies with a failed screen had CCHD, 47% had another disease process such as pulmonary pathology or sepsis, and 28% were well. Published data from New Jersey demonstrates that in asymptomatic babies with a failed CCHD screen, 10% had CCHD, 23% had another disease process causing hypoxemia, and 67% had non-critical congenital heart defect or were well. The differences between these two studies may be in part related to age at screening and a much higher prenatal detection rate of CCHD in New Jersey than in Sweden.

Newborn Screening for CCHD

Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Newborn Screening: Critical Congenital Heart Defects
Answers and Resources for Primary Care Pediatricians
Frequently Asked Questions
Topic 1: Rationale for CCHD Screening
Topic 2: Implementation of CCHD
Topic 3: CCHD Screening Data Collection and Management
Topic 4: Screening in Special Settings
Ask a CCHD Implementation question
Resources
State Implementation
References
Related AAP Policy Statements

Critical Congenital Heart Defects | CDC Critical Congenital Heart Defects
Critical Congenital Heart Defects
What are Critical Congenital Heart Defects (Critical CHDs)?
Some Specific Critical CHDs
Importance of Newborn Screening for Critical CHDs
How Newborn Screening for Critical CHDs is Done
Possible Physical Symptoms of Critical CHDs
Timing of Critical CHD Screening
Pulse Oximetry Screening Results
Pass
Fail
References
 The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a critical CHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Possible Physical Symptoms of Critical CHDs
Problems breathing
Pounding heart
Weak pulse
Very pale or blue skin color
Poor feeding
Very sleepy
Timing of Critical CHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CHDs. These seven defects are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as these seven and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven listed above. Pass
If the baby passes the screen (also called “negative” or “in-range” result), it means that the baby’s test results did not show signs of a low level of oxygen in the blood. A baby that passes the screen is unlikely to have a critical CHD.

Critical Congenital Heart Defects | CDC

The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a critical CHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination. Possible Physical Symptoms of Critical CHDs
Problems breathing
Pounding heart
Weak pulse
Very pale or blue skin color
Poor feeding
Very sleepy
Timing of Critical CHD Screening
Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age. Pulse Oximetry Screening Results
Pulse oximetry screening is most likely to detect seven of the critical CHDs. These seven defects are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as these seven and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven listed above. Pass
If the baby passes the screen (also called “negative” or “in-range” result), it means that the baby’s test results did not show signs of a low level of oxygen in the blood. A baby that passes the screen is unlikely to have a critical CHD.

Critical Congenital Heart Disease (CCHD) Screening Critical Congenital Heart Disease (CCHD) Screening
Section Menu
newborn-screening
Critical Congenital Heart Disease (CCHD) Screening
 Critical Congenital Heart Disease (CCHD) Screening
Section Menu
newborn-screening
Newborn Genetic Screening
For Parents
For Providers
Reports and Publications
Additional Resources
Newborn Hearing Screening
Critical Congenital Heart Disease (CCHD) Screening
Newborn Hearing Screening
For Parents
For Providers
Newborn Hearing Screening Resources
Newborn Genetic Screening
Critical Congenital Heart Disease (CCHD) Screening
For Parents
For Providers
Reports and Publications
Newborn Genetic Screening
Newborn Hearing Screening
Family Health and Wellness
Maternal and Child Health
Critical Congenital Heart Disease (CCHD) Screening
Critical congenital heart disease (CCHD) screening has been recommended nationally by the Secretary for Health and Human Services and pulse oximetry screening for CCHD is endorsed by the American Heart Association, American Academy of Pediatrics and American College of Cardiology. Congenital heart disease is the most common birth defect and may be detected during either the prenatal or postnatal period. Failing to detect CCHD while in the nursery may lead to serious events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Early detection of CCHD can potentially improve the prognosis and decrease the mortality and morbidity rate of affected infants. Pulse oximetry has been investigated and proven to be successful in detecting some forms of CCHD in the newborn nursery.

Critical Congenital Heart Disease (CCHD) Screening

Critical Congenital Heart Disease (CCHD) Screening
Section Menu
newborn-screening
Critical Congenital Heart Disease (CCHD) Screening

Critical Congenital Heart Disease (CCHD) Screening
Section Menu
newborn-screening
Newborn Genetic Screening
For Parents
For Providers
Reports and Publications
Additional Resources
Newborn Hearing Screening
Critical Congenital Heart Disease (CCHD) Screening
Newborn Hearing Screening
For Parents
For Providers
Newborn Hearing Screening Resources
Newborn Genetic Screening
Critical Congenital Heart Disease (CCHD) Screening
For Parents
For Providers
Reports and Publications
Newborn Genetic Screening
Newborn Hearing Screening
Family Health and Wellness
Maternal and Child Health
Critical Congenital Heart Disease (CCHD) Screening
Critical congenital heart disease (CCHD) screening has been recommended nationally by the Secretary for Health and Human Services and pulse oximetry screening for CCHD is endorsed by the American Heart Association, American Academy of Pediatrics and American College of Cardiology. Congenital heart disease is the most common birth defect and may be detected during either the prenatal or postnatal period. Failing to detect CCHD while in the nursery may lead to serious events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay. Early detection of CCHD can potentially improve the prognosis and decrease the mortality and morbidity rate of affected infants. Pulse oximetry has been investigated and proven to be successful in detecting some forms of CCHD in the newborn nursery.

Newborn Screening Process | Newborn Screening Newborn Screening Process
Newborn Screening Process
When Does Newborn Screening Happen?
Where Does NBS Happen?
How Does NBS Happen?
Blood Spot Screening
Pulse Oximetry Screening
Hearing Screening
Is NBS the Same for All Babies in the U.S.?
Parent Options During Screening
Differences in the Newborn Screening Panel
Before Newborn Screening: Questions to Ask
 The public health laboratory sends your baby’s results to your baby’s health care provider, not straight to you. If the result suggests the presence of a condition, then either the health care provider or the state NBS program will contact you. Be sure to ask about your baby’s results at your baby’s first or second well-child visit. It is important to ask about your baby’s NBS results—do not assume that no news means that the results are in-range. To learn more about blood spot screening results, visit the Newborn Screening Results and Follow-Up page. Pulse Oximetry Screening
Pulse oximetry screening uses a sensor to determine if your baby might have certain heart conditions called critical congenital heart disease (CCHD). CCHD is a group of serious heart conditions present at birth. Children with CCHD have any of a wide range of heart problems that arise when parts of the heart do not form correctly. In some forms of CCHD, the heart has trouble delivering oxygen from the lungs to the rest of the body. Babies with these forms of CCHD have low levels of oxygen in their blood.

The public health laboratory sends your baby’s results to your baby’s health care provider, not straight to you. If the result suggests the presence of a condition, then either the health care provider or the state NBS program will contact you. Be sure to ask about your baby’s results at your baby’s first or second well-child visit. It is important to ask about your baby’s NBS results—do not assume that no news means that the results are in-range. To learn more about blood spot screening results, visit the Newborn Screening Results and Follow-Up page. Pulse Oximetry Screening
Pulse oximetry screening uses a sensor to determine if your baby might have certain heart conditions called critical congenital heart disease (CCHD). CCHD is a group of serious heart conditions present at birth. Children with CCHD have any of a wide range of heart problems that arise when parts of the heart do not form correctly. In some forms of CCHD, the heart has trouble delivering oxygen from the lungs to the rest of the body. Babies with these forms of CCHD have low levels of oxygen in their blood.

Newborn Screening for CCHD Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Newborn Screening: Critical Congenital Heart Defects
Answers and Resources for Primary Care Pediatricians
Frequently Asked Questions
Topic 1: Rationale for CCHD Screening
Topic 2: Implementation of CCHD
Topic 3: CCHD Screening Data Collection and Management
Topic 4: Screening in Special Settings
Ask a CCHD Implementation question
Resources
State Implementation
References
Related AAP Policy Statements
 CHDs are the leading cause of birth defect-associated infant illness and death. About 18 per 10,000 babies are born with critical congenital heart defects (CCHDs, also known as critical congenital heart disease), which are life threatening and require catheter-based intervention or heart surgery during the neonatal period. Delayed diagnosis of CCHD may result in the child having a poorer preoperative condition and worse cardiopulmonary and neurological outcomes after treatment.
Why is CCHD screening so prominent now? Is it really a good use of limited resources? Why is CCHD screening so prominent now? Is it really a good use of limited resources? Studies from Europe and the United States have found that CCHD screening can be an effective way to detect serious health problems in otherwise well-appearing newborns. In addition to detecting CCHD, screening with pulse oximetry can detect other serious medical problems, including sepsis or pneumonia. As a result, the Secretary of Health and Human Services (HHS) recently recommended that screening for CCHD be added to the recommended uniform newborn screening panel. As with any other screening test, CCHD screening is not perfect.

Newborn Screening for CCHD

CHDs are the leading cause of birth defect-associated infant illness and death. About 18 per 10,000 babies are born with critical congenital heart defects (CCHDs, also known as critical congenital heart disease), which are life threatening and require catheter-based intervention or heart surgery during the neonatal period. Delayed diagnosis of CCHD may result in the child having a poorer preoperative condition and worse cardiopulmonary and neurological outcomes after treatment.
Why is CCHD screening so prominent now? Is it really a good use of limited resources? Why is CCHD screening so prominent now? Is it really a good use of limited resources? Studies from Europe and the United States have found that CCHD screening can be an effective way to detect serious health problems in otherwise well-appearing newborns. In addition to detecting CCHD, screening with pulse oximetry can detect other serious medical problems, including sepsis or pneumonia. As a result, the Secretary of Health and Human Services (HHS) recently recommended that screening for CCHD be added to the recommended uniform newborn screening panel. As with any other screening test, CCHD screening is not perfect.

Newborn Screening for CCHD Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Program to Enhance the Health & Development of Infants and Children (PEHDIC)
Newborn Screening: Critical Congenital Heart Defects
Answers and Resources for Primary Care Pediatricians
Frequently Asked Questions
Topic 1: Rationale for CCHD Screening
Topic 2: Implementation of CCHD
Topic 3: CCHD Screening Data Collection and Management
Topic 4: Screening in Special Settings
Ask a CCHD Implementation question
Resources
State Implementation
References
Related AAP Policy Statements
 There are some very uncommon reasons that CCHD screening might not be done (eg, babies who have an echocardiogram prior to discharge to home from the nursery or babies who have such serious medical conditions that no intervention would be done if CCHD were identified). Some parents might also refuse CCHD screening. In that case, parents should be educated about the benefits of screening and, if they still refuse, the refusal should be documented in the medical record. To avoid missing screening opportunities, plan to screen all newborns. Also, be aware of any state-specific rules, which may require that all newborns be screened.
Who should do the screening? CCHD screening should be conducted by individuals who have pulse-oximetry testing within their scope of practice, who are trained in the use of pulse oximetry and the CCHD algorithm, and who regularly use pulse oximetry for other purposes. Ultimately, the health care provider of record for each newborn is responsible for assuring that screening was appropriately completed.
What pulse-oximetry equipment should I use? Many pulse oximeters are currently available, and most hospitals have pulse oximeters already available. Only hospital-grade pulse oximeters designed for use in neon

Newborn Screening for CCHD

There are some very uncommon reasons that CCHD screening might not be done (eg, babies who have an echocardiogram prior to discharge to home from the nursery or babies who have such serious medical conditions that no intervention would be done if CCHD were identified). Some parents might also refuse CCHD screening. In that case, parents should be educated about the benefits of screening and, if they still refuse, the refusal should be documented in the medical record. To avoid missing screening opportunities, plan to screen all newborns. Also, be aware of any state-specific rules, which may require that all newborns be screened.
Who should do the screening? CCHD screening should be conducted by individuals who have pulse-oximetry testing within their scope of practice, who are trained in the use of pulse oximetry and the CCHD algorithm, and who regularly use pulse oximetry for other purposes. Ultimately, the health care provider of record for each newborn is responsible for assuring that screening was appropriately completed.
What pulse-oximetry equipment should I use? Many pulse oximeters are currently available, and most hospitals have pulse oximeters already available. Only hospital-grade pulse oximeters designed for use in neon

Screening Facts | Baby's First Test | Newborn Screening | Baby Health Newborn Screening 101
About Newborn Screening Newborn Screening 101
What is newborn screening
Newborn screening is the process of testing newborn babies for some serious, but treatable, conditions. NBS can include a heel stick, hearing screen, and pulse oximetry. The conditions that newborn babies are screened for varies by state.
?
Key Facts
Frequently Asked Questions
Q: My nurse said my baby needed a PKU test. Is a PKU test the same as newborn screening?
Q: Will the newborn screening blood test hurt my baby?
Q: Why are all babies screened at birth?
Q: Do parents have to ask for screening?
Today, EVERY baby can be screened.
Looking for more specific information?
Find a condition What your state offers
 can be offered to determine if the condition is truly present. Visit our testing outcomes page for more information. Key Facts
The conditions newborns are screened for differ in each state. Most states screen for 29 of the 35 conditions recommended by the Advisory Committee on Heritable Disorders in Newborns and Children. Although these conditions are rare, each year over 5,000 babies are identified with a newborn screening condition. There are three parts to newborn screening. A heel stick
When the baby's heel is pricked to collect a sample of blood for newborn screening
to collect a small blood sample
When blood is drawn from the human body in order to be tested for medical purposes
, pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery.

Screening Facts | Baby's First Test | Newborn Screening | Baby Health

Newborn Screening 101
About Newborn Screening Newborn Screening 101
What is newborn screening
Newborn screening is the process of testing newborn babies for some serious, but treatable, conditions. NBS can include a heel stick, hearing screen, and pulse oximetry. The conditions that newborn babies are screened for varies by state.
?
Key Facts
Frequently Asked Questions
Q: My nurse said my baby needed a PKU test. Is a PKU test the same as newborn screening?
Q: Will the newborn screening blood test hurt my baby?
Q: Why are all babies screened at birth?
Q: Do parents have to ask for screening?
Today, EVERY baby can be screened.
Looking for more specific information?
Find a condition What your state offers

can be offered to determine if the condition is truly present. Visit our testing outcomes page for more information. Key Facts
The conditions newborns are screened for differ in each state. Most states screen for 29 of the 35 conditions recommended by the Advisory Committee on Heritable Disorders in Newborns and Children. Although these conditions are rare, each year over 5,000 babies are identified with a newborn screening condition. There are three parts to newborn screening. A heel stick
When the baby's heel is pricked to collect a sample of blood for newborn screening
to collect a small blood sample
When blood is drawn from the human body in order to be tested for medical purposes
, pulse oximetry
Pulse oximetry, or pulse ox, is a painless, non-invasive test that measures how much oxygen is in the blood. Infants with heart problems may have low blood oxygen levels, and therefore, the pulse ox test can help identify babies that may have Critical Congenital Heart Disease (CCHD). The test is done using a machine called a pulse oximeter, which is a sensor placed on the baby’s skin. The pulse ox test only takes a couple of minutes and is performed after the baby is 24 hours old and before he or she leaves the newborn nursery.

State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014 State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014
State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014
Weekly
Discussion
References
Summary
 State mandates for newborn screening for CCHD will likely increase the number of newborns screened, allowing for the possibility of early identification and prevention of morbidity and mortality. Data collection at the state level is important for surveillance, monitoring of outcomes, and evaluation of state CCHD newborn screening programs. Congenital heart defects occur in approximately eight of every 1,000 live births, one fourth of which are considered to be CCHD ( 1 ). CCHD are defined as those requiring surgery or catheterization before age 1 year. In the absence of early detection, infants with CCHD are at risk for serious complications or death within the first few days or weeks of life ( 1 ). Newborn screening for CCHD uses pulse oximetry, a noninvasive technology to measure blood oxygen saturation. Low oxygen saturation indicates hypoxemia, an early clinical sign of CCHD. Additional testing (e.g., repeat screening, echocardiogram) is needed following an abnormal pulse oximetry screen ( 1) to determine whether CCHD are present (or to determine the cause of the abnormal result). Thus, unlike most newborn screening conditions, screening for CCHD is not based on performing a blood test. In addition, hypoxemia detected by screening could indicate a medical problem, and requires immediate follow-up before discharge from the hospital.

State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014

State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014
State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects — United States, 2011–2014
Weekly
Discussion
References
Summary

State mandates for newborn screening for CCHD will likely increase the number of newborns screened, allowing for the possibility of early identification and prevention of morbidity and mortality. Data collection at the state level is important for surveillance, monitoring of outcomes, and evaluation of state CCHD newborn screening programs. Congenital heart defects occur in approximately eight of every 1,000 live births, one fourth of which are considered to be CCHD ( 1 ). CCHD are defined as those requiring surgery or catheterization before age 1 year. In the absence of early detection, infants with CCHD are at risk for serious complications or death within the first few days or weeks of life ( 1 ). Newborn screening for CCHD uses pulse oximetry, a noninvasive technology to measure blood oxygen saturation. Low oxygen saturation indicates hypoxemia, an early clinical sign of CCHD. Additional testing (e.g., repeat screening, echocardiogram) is needed following an abnormal pulse oximetry screen ( 1) to determine whether CCHD are present (or to determine the cause of the abnormal result). Thus, unlike most newborn screening conditions, screening for CCHD is not based on performing a blood test. In addition, hypoxemia detected by screening could indicate a medical problem, and requires immediate follow-up before discharge from the hospital.