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We sometimes send patients home on a bili blanket. The light itself is a flexible rectangular object that fits along the front or back side of the baby. Once the baby is swaddled in it's blanket, you don't see anything except the "tubing" coming out of the blanket. It's difficult to describe, perhaps someone else here will do better!
I'm not totally sure if eye protection is still required? We actually have a home health nurse in the hospital that comes and does the consultation and teaching once home phototherapy is ordered. She then delivers, sets up, and reinforces the teaching at home.
Heather
Ahhh.... when all else fails, find a picture.
It is not rare at my hospital at all to send these babies home. Keeps health care costs down, and lets mom and baby do their bonding business. Our census is too high to allow moms to stay as patients because baby is jaundiced. They would have to be discharged.
Of course, this is only done if the doc, home health nurse, and nurses involved directly in their care are all confident in the patients ability to seek help if needed, use the equipment properly, and have adequate follow up. If any of these conditions aren't met, then they'd keep the baby as an inpatient.
Heather
As a NICU nurse, I was not about to leave my baby in the hospital for phototherapy! She was a healthy, breastfeeding 36 weeker with a bili of 18+, and went home on phototherapy.
The unit we used was called a "Wallaby". It was a fiberoptic "blanket" which wrapped around her midsection and was in continuous use. Eye protection was not needed. I kept a log of temperature, I&0, and activity levels. A home care nurse came for daily assessments including weight and heel-stick bili.
After 3 days, the lights were DC'd and we continued daily bili levels for another day or two. It was an easy course of therapy for us, but it has its limitations.
Babies who are poor feeders and/or dehydrated need IV therapy and nursing interventions aimed at improving feeding skills. (My little one was a chow hound, so this was not a problem.) Also, the "blanket" illuminates a relatively small surface area of skin, so babies with higher bili levels will not respond adequately to this treatment, needing standard lights, possibly in addition to lying on a bilil blanket.
My daughter is now almost 5 years old, so home phototherapy is old news to me. I'm surprised it's not more common in your areas. We were in Philadelphia, and I had 2 co-workers who did home phototherapy visits, so I know it was pretty widespread there. Maybe it's a regional thing.
The reason it is rare where I am, is cause bili's are often WAY high and they are getting double therapy, e.g. light PLUS blanket. And what happens after they go home, I don' t know. I am sure some jaundice is caught and treated at home...many DO get re-admitted to our floor for tx, tho, if it's high enough.
My daughter had a Wallaby. I was a rather PITA patient with her, and was somewhat uncooperative with the attempts to bottlefeed my baby (they put down an NG tube instead)...This was over 6 years ago. It was super, except for having to go daily for 10 days to have bili levels drawn at the lab.
greyhorse
19 Posts
The doctors at the facility where I work order inpt phototherapy. Usually in a room where the mother rooms in. I have just started working for an agency and when I worked this weekend we had a dr order a phototherapy 'belt' and light for the parents to use at home. This was new to me, how commonplace is this? What about concerns about dehydration, keeping eyes covered, and temperature regulation?
Greyhorse