TC Bilirubin checks...how often?

  1. I have recently moved to TX and am working in OB/L&D. Where I came from we had those done before discharge, routinely. At this hospital, they just got a transcutaneous bilimeter and have decided it needs to be done 2 hours after delivery and then BID 0800/2000. Then, of course, if it charts high, a serum bili is ordered. How often do you do it at your hospitals?
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  2. 7 Comments

  3. by   oceanwater16
    I also work in Texas and we do TC bili checks:

    1) Any time a baby looks yellow
    2) As soon as results are called that a baby is Coombs + (followed by serum at 24 hours)
    3) At 24 and 48 hours of age
  4. by   RNsweetie
    In my unit we call the lab to do this and we call it a bili index when a babe who is >37 weeks looks yellow (after 24 hrs of age, if before then serum), some babes go home without ever having a bili done (serum or index)

    The <37 weekers automatically get serum bili's done if appear jaundiced, no indexs for them.

    Erin
  5. by   midwife2b
    Babies who have more than just facial jaundice by 24 hr. of age...

    MOST of the breast feeding babies (part of a multicenter study being done) at 24 and 48 hr (if they are still there)

    Term stressed/resucitated babies at 24 hr.

    Any baby whose cord was not clamped by 5 min of age (some of the patients don't want the cord cut right away; again it is part of the multicenter study)

    Feeding difficulty any gestation
  6. by   SmilingBluEyes
    As above and within 6 hours of discharge on EVERY baby. If "high risk" (we plot on a graph based on age/other factors) we must follow up w/serum bili's.
  7. by   JaneyW
    We only do them if we suspect a high bili due to color and prior to discharge. It is followed by a serum if needed. There is no protocol for routine use except at discharge.
  8. by   Mythreeangels
    Does anyone know of a criteria estabished by any pediatric organizations?
  9. by   midwife2b
    Quote from Mythreeangels
    Does anyone know of a criteria estabished by any pediatric organizations?
    It is my understanding that there are false positives and negatives with the transutaneous device, and that is being looked at with the study our facility is involved in. Some babies who look yellow have had transutaneous and serum levels done at the same time, with discrepancies in the results.
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