TC bili meters

Elvish, BSN, DNP, RN, NP · Feb 16, 2009

We use Bilichek too....and no, I don't lift the meter between readings as a matter of routine. Sometimes if I've got a wiggly kid or something, it happens, but I don't do it intentionally. I've seen it be pretty accurate either way.

everthesame, LPN, LVN · Feb 16, 2009

When I worked nursery I tried not to lift it off of the baby but, of course, sometimes it happens. I don't think it makes a difference as long as it is positioned properly when you pull the trigger.

QTBabyNurse, BSN, RN · Feb 16, 2009

i haven't used the bilichek in the past year, but if it is still working the same as it did a year ago, i didn't raise it off the baby. i just did my 5 checks with it in the same place against the skin.

babyktchr, BSN, RN · Feb 17, 2009

If youi read the manufacturers book ( I had to do it) it recommends that you lift it off after each check. I am having a heck of a time with my bilicheck machine, having to send it back for repair for off readings. It is away more than it is on the unit. I am not happy with the response from the company or the reliability of the machine. You just don't know if you are out of range unless you happen to have to draw a serum. Anyone else having issues????

QTBabyNurse, BSN, RN · Feb 17, 2009

we used to routinely draw a serum if the tcb reading was 10 or more.

sometimes our tcb readings were off up to 3 from the serum results. it would be nice if they got those

meters to be a bit more accurate. i think they are a great tool and cut down on the amount of invasive

procedures.

Elvish, BSN, DNP, RN, NP · Feb 17, 2009

I think their intent is to be a screening tool only, not pinpoint accuracy. We don't use them on infants under 37-38 weeks, and if we get one that's even borderline-high for gestational age, we get a serum. For being a screening tool, they are awfully expensive.

KT-Jay731 · Feb 18, 2009

We are trained to lift them off the forehead after each "beep" but I have never actually seen anyone do it that way unless the baby is squirmy.

babyktchr, BSN, RN · Feb 20, 2009

These fabulously expensive machines are supposed to have an accuracy rate of +/- 1.5. We find that they are in that range most of the time, BUT if you aren't checking them routinely by serum, how do you really know? It is a non-invasive way to check bili, but really not reliable in the long run. And for as expensive as the machine is, they certainly do not have a well run repair/diagnostics group. They actually told me our "off readings" were lab error and not the machine. Ug.

Elvish, BSN, DNP, RN, NP · Feb 20, 2009

Ok, so we are not the only ones who have issues w/ repairing these things!!

rn/writer, RN · Feb 20, 2009

We use BiliCheks also. I lift the tip just enough to clear the skin and then put it right back down in the same spot.

We have two and it seems like they are quite temperamental. One trick I have learned is to swap out the battery if the meter is balky, even if it should have a full charge. That has helped a little. I really hate doing a test on a rooming-in baby and having the thing shut off on the last reading. Gaaahhhh!

Ours seem to be fairly accurate--within a point or two.

We test our kiddos on the second calendar day of life (noc shift) which puts them between 24 and 48 hours old. That way, if they need a serum bili, the lab techs just draw the extra tube with the state screen. The only ones we don't check with the bilimeter are those who already have a serum bili done or scheduled.

The nice thing is that we nurses can do a BiliChek any time we think a kid needs it, say, at twelve hours with a positive Coombs kid or when a baby has a large cephalohematoma. It's a nursing order. And we can order a serum bili as well. At the hospital where two of my daughters had babies last summer, the nurses couldn't do either without a doctor's order.

Oh, one other thing sometimes gets a bratty BiliChek to work. Threatening to heave it down an elevator shaft or send it sailing across the nursery has met with some success.

OzMW · Feb 20, 2009

I have personal experience with these (as a new mum) and little professional experience. The TCB reading said my babys level was fine- serum bili was extremely high requiring two days of photo therapy! How accurate are they supposed to be?