WESTERN CAPE 2006 CONSENSUS GUIDELINES

1 Health: KwaZulu-Natal Form Reference Number: Paed/34 Clinical Records: Paediatrics Neonatal Jaundice Monitoring Chart: phototherapy Name: Folder No: Date of birth: Time of birth: Birthweight: Gestation: Baby s Blood Group: Baby s Coomb s: Mother s Blood Group Use Exchange Transfusion chart overleaf if EXCHANGE TRANSFUSION is a possibility PHOTOTHERAPYWESTERN CAPE 2006 CONSENSUS GUIDELINES In presence of risk factors use one line lower (the gestation below) until < gestational age is accurate, rather use gestational age (weeks) instead of body weightStart intensive phototherapy when the TSB is the line accordinStart intensive phototherapy when the TSB is the line according to gestation or to gestation or under phototherapy : Check the TSB 12 24 hly but if TSB >30 mol/L above the line , check TSB 4 phototherapy .

2 If TSB > 50 mol/L below the line. Recheck TSB in 12 mol / L TSB (total serum bilirubin)Time (age of baby in hours)6h12h24h 36h 48h60h 72h84h 96h 108h 120hXXXXXXXXX38+ wks or 3000+g35 37w6d or 2500 2999g34 34w6d or 2000 2499g32 33w6d or 1500 1999g30 31w6d or 1250 1499g28 29w6d or 1000 1249g<28w or <1000gXInfants > 12 hours old with TSB level below threshold, repeat TSB level as follows: 1- 20 mol/L below line:repeat TSB in 6hrs or start phototherapy and rept TSB in 12- 24hrs,21 - 50 mol/L below line: repeat TSB in 12 24hrs, >50 mol/L below line: rept TSB until it is falling and/or until jaundice is clinically resolving Name:_____ Folder No:_____ Neonatal Jaundice Monitoring Chart: Exchange Transfusion EXCHANGE TRANSFUSIONWESTERN CAPE 2006 CONSENSUS GUIDELINESIn presence of sepsis, haemolysis, acidosis, or asphyxia, use one line lower (gestation below) until <1000gIf gestational age is accurate, rather use gestational age (weeks) than body weightNote: 1.

3 Infants who present with TSB above threshold should have Exchange done if the TSB is not expected to be below the threshold after 6 hrs of intensive Immediate Exchange is recommended if signs of bilirubin encephalopathy and usually also if TSB is >85 mol/L above threshold at presentation3. Exchange if TSB continues to rise >17 mol/L/hour with intensive phototherapyTime (age of baby in hours) 6h12h24h 36h 48h60h 72h84h 96h 108h 120h450440430420410400390380370360350340 3303203103002902802702602502402302202102 00190180 Micro mol / L TSB (total serum bilirubin)38+ wks or 3000+g35 37w6d or 2500 2999g34 34w6d or 2000 2499g32 33w6d or 1500 1999g30 31w6d or 1250 1499g28 29w6d or 1000 1249g<28w or <1000gXXX XXXXXXXX Record all TSB s, Hb/PCV s, phototherapy , baby s group and Coomb s, and mother s group in the designated places on the Newborn Care Record (Form Paed/01) 2