Critical Congenital Heart Disease Screening

Office of Children With Special Health Care Needs

Information for Hospitals and Birthing Facilities

CCHD Screening: Basic Facts

Learn More

Equipment Overview

Learn More

Reporting the CCHD Screening Result

Learn More

CCHD Screening Basic Facts

All newborns should be screened with pulse oximetry using the CCHD Screening Protocol Well Baby opens in a new tab.
Newborns in the NICU will be screened using the CCHD Screening Protocol NICU opens in a new tab.
Pulse oximetry screening does not replace a complete history and physical exam.
Screening should take place between 24 and 48 hours of life for healthy term newborns. Pulse oximetry has its lowest false positive rate if performed 24 hours after birth or later.
CCHD screening may be delayed in NICUs if the newborn is on oxygen. If early discharge is planned, screening should occur as late as possible prior to discharge.
Newborns who are on supplemental oxygen should have pulse oximetry screening deferred until they no longer need supplemental oxygen.
Screening should be done using the right hand and one foot, in parallel or in sequence.
An adequate waveform should be observed before pulse oximetry measurement is recorded.
Qualified personnel who have been educated in the use of the CCHD screening algorithm and trained in pulse oximetry monitoring of newborns should perform screening.
Any failed screen requires complete clinical evaluation.
Health care providers must understand the rationale for and limitations of pulse oximetry screening to detect CCHD.

Parents should be informed about CCHD Screening using pulse oximetry, including information about limitations of the screening.

CCHD Parent Fact Sheet opens in a new tab

Administration

Each hospital should develop a policy for pulse oximetry screening that includes screening procedures, documentation, and reporting of results.
Each hospital should establish a plan for management and evaluation of newborns who fail the CCHD screening.
Each hospital should provide training in newborn pulse oximetry to individuals who will be involved in the screening process.

Equipment Overview

A variety of pulse oximeters are available for use in newborns. Important features to look for when choosing a pulse oximeter are:

FDA approval for use in newborns
Screening should be completed with motion tolerant pulse oximeters that report functional oxygen saturation.
Manufacturer-recommended pulse oximeter-probe combinations should be used.
Pulse oximeters can be used with either disposable or reusable probes

Both disposable and reusable probes with a disposable foam wrap are available.
Probes are available in two sizes: neonatal probes for newborns weighing less than 3 kilograms, and infant probes for newborns weighing 3 kilograms or more.

Reporting the CCHD Screening Result

Reporting of CCHD Screening is covered by Birth Defect Reporting Rule R398-5 opens in a new tab. The vital records clerks at each birthing facility will be trained to locate the CCHD screening results and record one of three options (Pass, Fail, Not Screened) on the birth record.

Results of the newborn CCHD screening should be communicated to the newborn’s primary care provider and an appropriate mechanism should be established to ensure that the results of the pulse oximetry screening are recorded in the chart.

CCHD Screening SpO2 results are usually provided electronically on a monthly basis through the hospital’s data team. Hospitals with lower birth volumes may elect to report using alternative mechanisms such as “HiTrack”, fax or email.

Newborns and children diagnosed with CCHD are reported to the Utah Birth Defect Network. All newborns diagnosed with CCHD, including those diagnosed prenatally, on newborn physical exam, through CCHD Screening, and later clinical presentation (up to two years of age) are included in this registry.