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Bilirubin Meter

  Review any risk factors for hyperbilirubinemia that apply to the infant.

Verify the length of time after birth that jaundice appears.

Observe areas of the infant body that display jaundice. To assess jaundice, depress skin over a bony area and observe for the yellow hue under natural light, if possible. On dark-skinned or Asian infants, jaundice may be difficult to ascertain. Jaundice usually appears in the following progression:
  • Head
  • Sclera
  • Chest
  • Abdomen
  • Legs
  • Soles of feet
  1. Gather equipment and clean as necessary.
  2. Expose the infant's forehead or sternum.
  3. Perform hand hygiene and apply clean gloves.
  4. Verify the patient's identity using two patient identifiers in accordance with institutional policy.
  5. Turn on the TCB and calibrate per the manufacturer's instructions. Place the disposable tip per the manufacturer's instructions.
  6. Quickly compress and remove the tip lightly against a body prominence such as the infant's forehead and/or sternum.
  7. Obtain reading per the manufacturer's instructions.
  8. Bundle the infant as necessary to maintain warmth.
  9. Remove gloves and discard with supplies in proper trash receptacles. Perform hand hygiene.
  10. Notify the physician for TCB levels exceeding 6 mg/dl within 24 hours of birth or if plotted above the 75th percentile on the Bhutani curve.
  11. Monitor TCB and TSB levels as indicated by institutional policy and/or the physician's orders.
  12. Document the procedure in the patient's record.