Abstract
Objective This study was designed to describe our experience in implementing the American Academy
of Pediatrics (AAP) recommendation to test infants in a car bed if they fail a car
seat challenge test.
Study Design Car seat challenge testing was performed for 90 minutes or the anticipated duration
of the trip home, whichever was longer. Based on the pulse oximetry saturation values
(90–92% or < 90%) two categories of test failure were used. Infants who failed in
the car seat were tested in the car bed. Testing took place in both the normal newborn
nursery (NBN) and special care nursery (SCN). NBN babies who failed in the car bed
were transferred to our SCN for additional assessment and management.
Results A total of 197 infants were tested in car seats out of which 177 (89.8%) passed the
test. Of the 20 infants who failed, 16 passed the car bed challenge test on the first
attempt and were discharged in those devices. All infants who failed the car bed challenge
were NBN patients.
Conclusions Using 93% as the acceptable lower limit of oxygenation we successfully implemented
the AAP recommendations for car bed challenge testing in our nursery.
Keywords
car seats - car beds - oxygen desaturation - apnea - bradycardia
