新生儿先天性心脏病筛查VIP免费

NewbornScreeningforCriticalCongenitalHeartDiseaseEducationforNursesThepurposeoftheCongenitalHeartDisease(CHD)ScreeningProgramistoidentifynewbornswithCHDpriortoclinicaldeteriorationoftheaffectedinfant.Delayeddiagnosisofcriticalcongenitalheartdisease(CCHD)canresultindeathorinjurytoinfants.Whydoweneedtoscreen?TheDepartmentofHealthandHumanServiceshereintheUnitedStatesmadethisCHD(alsocalledCCHD—CriticalCongenitalHeartDisease)screeningrecommendationSeptemberof2011.InJanuaryofthisyear,theAmericanAcademyofPediatricsendorsedthisrecommendation.OurOB–PEDSteamhasrecentlyapprovedthepolicyandwearereadytogetstartednow!Wehadsomequestionstoansweraboutnewbornechocardiogramsbeforewecouldgetstarted!Whoendorsesthis?Congenitalheartdefects(CHDs)accountfor24%ofinfantdeathsduetobirthdefects.IntheUnitedStates,about4,800(or11.6per10,000)babiesborneveryyearhaveoneofsevencriticalcongenitalheartdefects(CCHDs,whichalsoareknowncollectivelyinsomeinstancesascriticalcongenitalheartdisease).CCHDFactSheetSevenofthemostcommonCRITICALCONGENITALHEARTDEFECTSare:HypoplasticLeftHeartPulmonaryAtresiaTetralogyofFallotTranspositionoftheGreatArteriesTricuspidAtresiaTruncusArteriosusTotalAnomalousPulmonaryvenousReturnWhatareCCHD’s?BabieswithoneoftheseCCHDsareatsignificantriskofdisabilityordeathiftheirCCHDisnotdiagnosedsoonafterbirth.ThesesevenCCHDsamongsomebabiespotentiallycanbedetectedusingpulseoximetryscreening,whichisatesttodeterminetheamountofoxygeninthebloodandpulserate.SevenCommonCCHD’sSomebabiesbornwithaheartdefectcanappearhealthyatfirstandcanbesenthomewiththeirfamiliesbeforetheirheartdefectisdetected.Ithasbeenestimatedthatatleast280infantswithanunrecognizedCCHDaredischargedeachyearfromnewbornnurseriesintheUnitedStates.Thesebabiesareatriskforhavingseriouscomplicationswithinthefirstfewdaysorweeksoflifeandoftenrequireemergencycare.WhyisthisImportant?NewbornscreeningusingpulseoximetrycanidentifysomeinfantswithaCCHDbeforetheyshowsignsofaCCHD.Onceidentified,babieswithaCCHDcanbeseenbycardiologistsandcanreceivespecializedcareandtreatmentthatcouldpreventdeathordisabilityearlyinlife.Treatmentcanincludemedicationsandsurgery.WhyPulseOximetry?Pulseoximetryisasimplebedsidetesttodeterminetheamountofoxygeninababy’sbloodandthebaby’spulserate.LowlevelsofoxygeninthebloodcanbeasignofaCCHD.Screeningisdonewhenababyis24to48hoursofage,oraslateaspossibleifthebabyistobedischargedfromthehospitalbeforeheorsheis24hoursofage.Pulseoximetryscreeningdoesnotreplaceacompletehistoryandphysicalexamination.Whenarebabiesscreened?MakethenewborniswarmandquietKnowhowtocorrectlyusetheequipmentandwheretogetsupplies.Makesureyouaregettingaccuratereadingsbyassuringagoodwaveformandheartrateonthemonitor.ALWAYSusetherighthandandrightfootPractice!HowcanIhavethemostsuccess?RightHandandRightFootWheredoperformthetestonthebaby?Anurseshouldperformthetestafter24hoursofageorascloseaspossibletodischargeALLNEWBORNSWILLBESCREENEDUsetheAlgorithmstodeterminewhattodo.Thereisapassingalgorithmandafailingalgorithm.Whoperformsthetest?1.PlaceO2SatProbeonthenewbornsrighthandorrightfootfirst.O2satprobesareachargeitemandinPyxis.Thereare2sizestochoosefromNeo-LandInf-L,bothmadebyMasimo.2.Recordthereadingandthenswitchtowhateverextremityyoudidn’tstartwith.ONLYscreenRighthandandRightfoot.StepOne…IftheNewborn’ss...