TCB's

[scrubnurse]

Anyone using Bilichecks for TCB's? Do you turn off the room lights/dim the lights before using it? At my old hospital we were taught to use it in a dim/darkened room. I recently changed hospitals, and they do their TCB's with lights on. They said they had never heard of having to turn lights off. I have tried to research this online, even with bilicheck manual, but can't seem to find an answer of if it makes a difference. Also, what about drawing serum bili's? Had a nurse once say that you should draw serum bili in a darkened room. I'm not referring to bili lights, I know you obviously would want those off, but I'm talking about regular room lights. Any thoughts?

TIA!

[littleneoRN]

We don't use the TCB, but in regards to serum bili. I have worked at two facilities. Both turn the bili lights off, neither draws in a darkened room, and one puts the bili in an amber tube. (The other runs their specimens quite quickly...don't know how much difference this makes).

Wikipedia (always a great source, I know..) cites this study

Leung C, Soong WJ, Chen SJ (July 1992). "[Effect of light on total micro-bilirubin values in vitro]" (in Chinese). Zhonghua Yi Xue Za Zhi (Taipei) 50 (1): 41–5. PMID 1326385

saying that samples of blood exposed to phototherapy had a significant decrease in bilirubin level at 2 hours (the first interval checked) but that samples exposed to typical white light did not until 6 hours. So if you're running the sample in a timely manner, room light should not make a difference.

[Chazd18RN]

We do TCB's every morning and upon discharge. We only draw TSB's (total serum bili level) if the TCB result falls in the high intermediate risk zone or the high risk zone of the bili chart that we have. We have not been instructed to check TCB's in dim lights, and I did not remember reading that in the instruction mannual. TSB's are drawn with the regular lights on, but of course the bili light is turned off.

[babyktchr, BSN, RN]

We just had the bilichek rep in to do another inservice and she instructed us to perform the test in as much natural light as possible. We use a chart for when to draw serum, and as someone else said, it is when the TCB is above 75% percentile (by age in hours). If you are using lights, you should not use TCB unless you are using a guard on the spot where you are placing the bilichek (the company makes those). I am not finding this machine as reliable as the company makes it out to be. I have actually taken ours out of service because of huge discrepancies. I am looking at their newer model now.

[klone, MSN, RN]

We do TCB's every morning and upon discharge. We only draw TSB's (total serum bili level) if the TCB result falls in the high intermediate risk zone or the high risk zone of the bili chart that we have. We have not been instructed to check TCB's in dim lights, and I did not remember reading that in the instruction mannual. TSB's are drawn with the regular lights on, but of course the bili light is turned off.

This is exactly us too. TCBs on all babies before discharge, and PRN. I've never heard of needing to dim the regular fluorescents.

[OB_RN_Heather]

We use the bili check meter at 24hrs of life and before discharge ( usually early in the morning the day of discharge). I work night shifts so I keep the lights in the room dimmed. I have not heard that it is necessary to get an accurate reading. We too use a graph to determine if the newborn has jaundice. I have though accidentally miss calculated the hours before and the pediatrician pointed out the error. I found a good app for OB nurses that determines the hours of life of baby, called Nurse Aid.

[mikhy]

what is the full name of "TCB" ?

thank you !

[rn4babies63]

what is the full name of "TCB" ?

thank you !

Transcutaneous bilirubin

[k.willow]

I'm not sure if there is some research out there that supports this, but when we do TCBs we do them in low light. Whenever I've had a number that was higher than expected, I always check to see how it was done and repeat in lower light. We usually get a lower, more accurate, number with the lights dimmed. (Based on serums sent right after TCB)

[klone, MSN, RN]

For anyone else who is a trivia dork like I am, the bilirubin chart is called the Bhutani nomogram

[BSNbeauty, BSN, RN]

Is there a chart or algorithim for the results for TCB. We have a graph but it is so hard to read. Can anyone help with this? Thanks.