This wheel is designed as an educational tool to help assess for Critical Congenital Heart Disease (CCHD) in neonates. Pulse Oximetry has been recommended by the American Academy of Pediatrics and the American Heart Association to identify hypoxemia that might not otherwise produce visible cyanosis, especially among darkly pigmented newborns. Pulse oximetry screening before 24 hours of life can result in false-positive results, therefore testing ≥24 hours after birth is recommended. Technical limitations to pulse oximetry measurements in the newborn include: falsely low oximetry readings due to motion artifact, probe placement site, partial probe detachment and hyperbilirubenimia. Also, some variability among commercially available pulse oximeters exists, but in the critical range for oximetry screening (94% to 97%), the variability is negligible. Parents and caretakers should also be informed that pulse oximetry cannot detect all cases of CCHD, and a negative test does not exclude the possibility of heart disease.

The wheel has 4 circles that are all color coded for easy reading. Start at the center circle and move outward as you assess the patient and each condition.