| What is stated about variations in patient management in the STW? | variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. | 262 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf | There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. | 1 | page=1,block=1 | 0.700 | valid |
| What are the symptoms of heart failure in a baby? | Tachypnoea, Tachycardia, Tender Hepatomegaly | Heart Failure Look for Tachypnoea, Tachycardia, Tender Hepatomegaly Is the baby sucking from the Feeding Normal: sucking vigorously, no suck rest suck breast breast normally? cycle, no breathlessness/ forehead sweating while feeding, no prolonged feeding times AS: Aortic Stenosis L->R: Left to Right PV: Pulmonary Valve TV: Tricuspid Valve AV: Aortic Valve MV: Mitral Valve TAPVC: Total anomalous pulmonary VSD: Ventricular Septal CCHD: Cyanotic Congenital Heart Disease PA: Pulmonary Artery Venous Connection Defect CHD: Congenital Heart Disease PG E1: Prostaglandin E1 TGA: Transposition of Great Arteries HLHS: Hypoplastic Left Heart Syndrome PS: Pulmonary Stenosis TOF: Tetralogy of Fallot 1. Gupta SK. Congenital heart disease. In Agarwal R, Deorari A, Paul V, Sankar MJ, Sachdeva A (Eds), AIIMS protocols in Neonatology. Noble Vision Medical Books Publishers, New Delhi 2019. Page 150-164 2. | 23 | list | 0.740 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf | Heart Failure Look for Tachypnoea, Tachycardia, Tender Hepatomegaly Is the baby sucking from the Feeding Normal: sucking vigorously, no suck rest suck breast breast normally? cycle, no breathlessness/ forehead sweating while feeding, no prolonged feeding times AS: Aortic Stenosis L->R: Left to Right PV: Pulmonary Valve TV: Tricuspid Valve AV: Aortic Valve MV: Mitral Valve TAPVC: Total anomalous pulmonary VSD: Ventricular Septal CCHD: Cyanotic Congenital Heart Disease PA: Pulmonary Artery Venous Connection Defect CHD: Congenital Heart Disease PG E1: Prostaglandin E1 TGA: Transposition of Great |
| How long after the first measurement should the second pulse oximetry measurement be taken? | 1 hour after measurement 1 | Measurement 1 Pulse oximetry on right arm and 1 foot around 24 hours of age (or earlier, if being discharged) Measurement 2 Pulse oximetry on right arm and 1 foot 1 hour after measurement 1 Fail Pulse oximetry of 89% or less in either the right arm or foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Fail a) Pulse oximetry of 94% or less in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care Retest a) Pulse oximetry of 90% to 94% in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Repeat pulse oximetry measurements Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care July/ 2024 | 163 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf |
| What action should be taken if pulse oximetry is 89% or less in either the right arm or foot? | Do not repeat pulse oximetry screening, refer for immediate assessment | Measurement 1 Pulse oximetry on right arm and 1 foot around 24 hours of age (or earlier, if being discharged) Measurement 2 Pulse oximetry on right arm and 1 foot 1 hour after measurement 1 Fail Pulse oximetry of 89% or less in either the right arm or foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Fail a) Pulse oximetry of 94% or less in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care Retest a) Pulse oximetry of 90% to 94% in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Repeat pulse oximetry measurements Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care July/ 2024 | 265 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf |
| What are the guidelines in the STW based on? | expert opinions and available scientific evidence | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. | 198 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf | These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. | 1 | page=1,block=1 | 0.700 | valid |
| What is the action if a newborn fails the pulse oximetry screening with a reading of 94% or less in the right arm or foot? | Do not repeat pulse oximetry screening, refer for immediate assessment | Measurement 1 Pulse oximetry on right arm and 1 foot around 24 hours of age (or earlier, if being discharged) Measurement 2 Pulse oximetry on right arm and 1 foot 1 hour after measurement 1 Fail Pulse oximetry of 89% or less in either the right arm or foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Fail a) Pulse oximetry of 94% or less in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care Retest a) Pulse oximetry of 90% to 94% in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Repeat pulse oximetry measurements Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care July/ 2024 | 265 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf |
| What is the liability status for consequences mentioned in the STW? | There will be no indemnity for direct or indirect consequences. | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. | 391 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf | There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. | 1 | page=1,block=1 |
| What should be done if a baby has bluish discoloration of extremities to rule out peripheral cyanosis? | warm the baby and re check | Likely obstructed TAPVC -Immediate referral Yes Yes No Significant congenital heart disease likely ASK/LOOK/FEEL CATEGORY INTERPRETATION Does the baby have decreased Activity and feeding Decreased activity is a common presentation of activity and feeds poorly? heart failure/shock in neonates Is the baby cyanotic? Pulse Cyanosis/Desaturation Look for bluish discolouration of fingers and Oximetry screen tongue. If extremities are blue, to rule out peripheral cyanosis- warm the baby and re check Is there any evident respiratory Respiration Chest indrawing/grunting/use of accessory distress or Tachypnoea? muscles/RR more than 60 per minute Does the baby have Inappropriate Heart Rate Normal awake new born 100-180 normal sleeping Tachycardia/Bradycardia new born 80-160 Is the baby in shock? | 471 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf | If extremities are blue, to rule out peripheral cyanosis- warm the baby and re check Is there any evident respiratory Respiration Chest indrawing/grunting/use of accessory distress or Tachypnoea? muscles/RR more than 60 per minute Does the baby have Inappropriate Heart Rate Normal awake new born 100-180 normal sleeping Tachycardia/Bradycardia new born 80-160 Is the baby in shock? |
| When should the first pulse oximetry measurement be taken for a newborn? | around 24 hours of age (or earlier, if being discharged) | Measurement 1 Pulse oximetry on right arm and 1 foot around 24 hours of age (or earlier, if being discharged) Measurement 2 Pulse oximetry on right arm and 1 foot 1 hour after measurement 1 Fail Pulse oximetry of 89% or less in either the right arm or foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Fail a) Pulse oximetry of 94% or less in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Do not repeat pulse oximetry screening, refer for immediate assessment Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care Retest a) Pulse oximetry of 90% to 94% in either the right arm or foot or b) A difference of 4% or more between the right arm and foot Action: Repeat pulse oximetry measurements Pass Pulse oximetry of 95% or more in right arm and foot and a difference of 3% or less between the 2 Action: Do not repeat pulse oximetry screening, provide normal newborn care July/ 2024 | 53 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf |
| Which organization is associated with the preparation of the STW? | Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. | 547 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651147_2_critical_heart_disease_in_the_newborn.pdf | ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. | 1 | page=1,block=1 | 0.700 | valid |