Pulse Oximetry

While addressing the most common causes of Infant Mortality within Congenital Anomalies, the need for identifying CHD early for early referral and Treatment is understood. Two measures were planned and implemented to facilitate early case identification of Congenital Heart Diseases. They were Fetal Heart screening during second trimester Ultrasound and Neonatal Pulse Oximetry screening before 48 hours and after 24 hours of birth. Staff Nurses were identified and trained to do PO screening, and separate PO machines were provided to screening corners in all public sector delivery points. The screening information was synchronised with the birth defect screening software, and protocols were established to ensure that care and treatment to those children were tested positive. Each baby will be brought to the Screening corner after 24 hours of their birth, preferably before 48 hours. The caretaker will be asked to bring the baby after feeding and well covered. The screening nurse will identify the unique VBD number of the baby from the case sheet or any other available document.

The Pulse Oximeter specifically made available for screening has a software called Eve, which will capture the PO value and store it against the unique VBD number that will be transferred to the portal. If the PO value in either limb is less than 90, the child will be considered as tested failed and referred to the pediatrician for checking and referring for ECHO if necessary. Those found to have PO value less than 95 in either of the limb or if the difference between upper and lower limb is more than 3, then the test is repeated after 15 minutes and within one hour. If the result is same the baby will be referred to Pediatrician as above. The child referred to get an ECHO done will report back to the screening nurse with the ECHO report and if found to have any CHD, will be registered in hridyam.kerala.gov.in as a new case and followed up.