Counsel parents of a newborn with a suspected duct-dependent cardiac lesion — OSCE

OSCE communication and shared-planning station: explaining to the parents of a newborn found to have a low saturation on pulse-oximetry screening the meaning of the finding, the immediate plan to start prostaglandin E1 and transfer to a cardiac centre before the echocardiogram, and the honest framing of prognosis while addressing fear.

osce communication and shared decision-making2 min readVerification in progress

Prompt

The parents of a thirty-hour-old term infant, found on the postnatal ward to have a pulse-oximetry of 86 per cent in air while looking well, are frightened and bewildered. They have been told their baby needs a drip of a drug they have never heard of and transfer to a city cardiac centre before a scan has even been done. They do not understand why their baby looks well yet is being treated as an emergency. Counsel them.

Candidate brief

You have eight minutes to counsel the parents of a thirty-hour-old term infant found on routine pulse-oximetry screening to have a saturation of 86 per cent in air while looking well. The plan is to start a prostaglandin infusion and transfer to a cardiac centre before the echocardiogram. Use a structured, honest and empathic approach that explains the finding in plain language and builds a shared plan. [2] [1]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References4Show ledger

[2]Mahle WT, Newburger JW, Matherne GP, et al. Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation, 2009.PMID 19581492
[1]de-Wahl Granelli A, Wennergren M, Sandberg K, et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns. BMJ, 2009.PMID 19131383
[8]Aykanat A, Yavuz T, Özalkaya E, et al. Long-Term Prostaglandin E1 Infusion for Newborns with Critical Congenital Heart Disease. Pediatr Cardiol, 2016.PMID 26260095
[9]Vari D, Xiao W, Behere S, et al. Low-dose prostaglandin E1 is safe and effective for critical congenital heart disease: is it time to revisit the dosing guidelines? Cardiol Young, 2021.PMID 33140712