Pulse oximetry screening of the well newborn to assist in the diagnosis of critical congenital\nheart disease (CCHD) is increasingly being adopted. There are advantages to diagnosing CCHD\nprior to collapse, particularly if this occurs outside of the hospital setting. The current recommended\napproach links pulse oximetry screening with the assessment for CCHD. An alternative approach\nis to document the oxygen saturation as part of a routine set of vital signs in each newborn infant\nprior to discharge, delinking the measurement of oxygen saturation from assessment for CCHD.\nThis approach, the way that many hospitals which contribute to the Australian New Zealand\nNeonatal Network (ANZNN) have introduced screening, has the potential benefits of decreasing\nparental anxiety and expectation, not requiring specific consent, changing the interpretation of false\npositives and therefore the timing of the test, and removing the pressure to perform an immediate\nechocardiogram if the test is positive. There are advantages of introducing a formal screening\nprogram, including the attainment of adequate funding and a universal approach, but the barriers\nnoted above need to be dealt with and the process of acceptance by a national body as a screening\ntest can take many years.
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