A Single-Extremity Staged Approach for Critical Congenital Heart Disease Screening: Results from Tennessee

Abstract

Abstract:Tennessee initiated single-extremity staged screening by pulse oximetry for undetected CCHD in 2012. The algorithm begins with a saturation reading in the foot and allows an automatic pass if the foot pulse oximetry is 97% or greater. This was based on the principle that it is not possible to have a greater than 4% difference in the pulse oximetry between upper and lower extremities if the lower extremity is equal to or greater than 97%. This approach eliminates over 75,000 "unnecessary" pulse oximetry determinations in Tennessee each year without affecting the ability to detect CCHD before hospital discharge.

Pulse Oximetry Screening for Critical Congenital Heart Defects: A Life-Saving Test for All Newborn Babies

“…Most of the recent recommendations advocate dual site measurements, but Riede and colleagues recommend post-ductal saturation measurement only [33]. An interesting alternative strategy is proposed by Walsh and Ballweg from Tennessee USA, who advocate post-ductal saturations with a higher threshold (97%) for the initial screen and then pre-and post-ductal saturations for those who require a repeat [43].…”