Current through Register Vol. 39, No. 6, September 16, 2024
(a) All medical
facilities and attending providers of a neonate or infant shall assure the
following:
(1) Screening of every neonate for
critical congenital heart defects (CCHD) using pulse oximetry shall be
performed at 24 to 48 hours of age using a written protocol developed by the
provider based upon and in accordance with the most current recommendations
from the American Academy of Pediatrics and American Heart Association
(AAP/AHA) which are incorporated by reference including subsequent amendments
and editions, unless a diagnostic neonatal echocardiogram has been performed. A
copy of the recommendations is available for inspection at the NC Division of
Public Health, Women's and Children's Health Section, Children and Youth
Branch, 5601 Six Forks Road, Raleigh, NC 27609. In addition, the
recommendations can be accessed at the American Academy of Pediatrics website
at:
http://pediatrics.aappublications.org/content/128/5/e1259.full.pdf+html?sid=85e81711-f9b8-43d1-a352-479168895a72.
(2) Screening of a neonate for CCHD who is
born in a free-standing birthing center or home may occur as early as 6 hours
of age but shall not occur later than 48 hours of age using the AAP/AHA
recommendations.
(3) Screening of
neonates and infants in neonatal intensive care units for critical congenital
heart defects using pulse oximetry screening shall be performed using a written
protocol based on the AAP/AHA recommendations as soon as the neonate or infant
is stable, as determined by the attending provider, and off oxygen and before
discharge unless a diagnostic echocardiogram is performed on the neonate or
infant after birth and prior to discharge from the medical facility.
(4) Only U.S. Food and Drug Administration
approved pulse oximetry equipment is used and maintained to screen the neonate
or infant for the presence of critical congenital heart defects.
(b) Parents or guardians may
object to the critical congenital heart defects screening at any time before
the screening is performed in accordance with
G.S.
130A-125.
(c) All medical facilities and attending
providers of the neonate or infant shall have and implement a written protocol
developed by the provider for evaluation and follow up of positive critical
congenital heart defect screenings.
(1)
Evaluation and follow up of a positive screening for all neonates shall occur
as soon as possible but no later than 24 hours of obtaining a positive
screening result. Evaluation and follow-up shall be in accordance with the most
current published recommendations from the American Academy of Pediatrics and
American Heart Association (AAP/AHA) which is incorporated by reference
including subsequent amendments and editions. A copy of the recommendations is
available for inspection at the NC Division of Public Health, Women's and
Children's Health Section, Children and Youth Branch, 5601 Six Forks Road,
Raleigh, NC 27609. In addition, the recommendations can be accessed at the
American Academy of Pediatrics website at:
http://pediatrics.aappublications.org/content/128/5/e1259.full.pdf+html?sid=85e81711-f9b8-43d1-a352-479168895a72.
(2) Attending providers of
neonates and infants in neonatal intensive care units must have a written
protocol developed by the provider for evaluation and follow up of positive
screenings in place at their medical facility.
(3) Options for neonatal or infant
echocardiograms may include on-site, telemedicine, or by transfer or referral
to an appropriate medical facility with the capacity to perform and interpret a
neonatal or infant echocardiogram. Echocardiograms must be interpreted as
recommended by the most current recommendations from the AAP/AHA, which are
incorporated by reference including subsequent amendments and editions. A copy
of the recommendations is available for inspection at the NC Division of Public
Health, Women's and Children's Health Section, Children and Youth Branch, 5601
Six Forks Road, Raleigh, NC 27609. In addition, the recommendations can be
accessed at the American Academy of Pediatrics website at:
http://pediatrics.aappublications.org/content/128/5/e1259.full.pdf+html?sid=85e81711-f9b8-43d1-a352-479168895a72.
