Jaundice - Transcutaneous Bilirubinometry Procedure 51118
Jaundice - Transcutaneous Bilirubinometry Procedure 51118
Jaundice - Transcutaneous Bilirubinometry Procedure 51118
Key Points
Each TcB meter must have an operational check completed prior to use each day
Screen babies visibly jaundiced if ≥35/40 and >24 hours of age, or at time of their newborn screen
Screen babies who are DAT positive without visible jaundice, including if <24 hours of age and discuss
result with Neonatal RMO
SBR should be performed if TcB is above the set cut-off level
SBR must be urgently performed if TcB is >300 or a warning TcB level is displayed e.g. 000 / -0- / - - -
1. Purpose
This procedure outlines the requirement for use of transcutaneous bilirubinometry for babies at the Women’s.
This procedure is related to: Jaundice (hyperbilirubinaemia) in newborn babies ≥ 35 weeks gestation
Where processes differ between campuses, those that refer to the Sandringham campus are differentiated by
pink text or have the heading Sandringham campus (W@S).
3. Responsibilities
All nurses, midwives and medical staff caring for babies at The Women’s.
4. Procedure
A range of Drager TcB meters are in use at the RWH and Sandringham.
Each device requires a daily operational check prior to use (details are on a laminated sheet attached to each
device)
TcB meters are used to screen and determine the need for SBR testing in:
babies ≥35/40 and >24 hours of age who are visibly jaundiced, and who are neither receiving, or
previously received, phototherapy
all babies ≥35/40 who are not visibly jaundiced, at the time of their newborn screening test, either prior
to discharge or at home,
babies who are DAT positive and at risk of significant jaundice, but who are not visibly jaundiced and
who may be <24 hours of age – all results to be discussed with Neonatal RMO
g. If the meter was set to take more than one measurement lift the meter from the skin between
measurements. Average results will be displayed and this value should be documented.
4.2 Documentation of TcB results
To avoid any confusion with SBR results, clearly record the result as a TcB level in micromol/L (µmol/L)
Document the TcB result, including date and time, on:
- the ‘Baby Observation and Feed Chart’ (MR/379a) in Maternity
- the ‘Neonatal Intensive and Special Care Chart’ in NICU (MR/96)
- the ‘RWH Emergency Department Clinicians Record (MR/43036) in WEC
- the ‘Neonatal Graphic Observation and Response Chart MR R61N in section ‘other’ (Sandringham)
6. References
1. Drager Jaundice meter JM-103. Sample usage protocol template.
2. RPA newborn care guidelines. (2006) Transcutaneous bilirubinometers. Sydney: Royal Prince Alfred
Hospital http://www.sswahs.nsw.gov.au/rpa/neonatal/html/docs/bilirubinometers.pdf
3. RWH guideline: Jaundice (hyperbilirubinaemia) in newborn babies ≥ 35 weeks gestation
4. W@S Procedure: Jaundice (Hyperbilirubinaemia) in Newborn Babies more than 35 Weeks Gestation
8. Appendices
Not applicable.