Neonatal Hyperbilirubinemia Tool

Introduction:

This is a web-based tool for managing neonatal hyperbilirubinemia. It will make suggestions for management of newborns, using information that you provide including birth time, risk factors, and bilirubin values.

It is ONLY compatible with Internet Explorer! The GUI will not work with other browsers (Mozilla, Chrome, Opera). Sorry! You should use the original bilirubin page if you are going to use those browsers - but there is no GUI :(

Instructions:

1. Enter birth date and time:  

2. Select risk factors, if present:
   Major risk factors:
   • gestational age 35 to 37+6/7weeks
   • hemolytic disease (ABO/Rh incompatibility, hemoglobinopathy, polycythemia)
   • temperature instability lethargy acidosis sepsis asphyxia albumin < 3.0g/dL G6PD
   • other (sick-appearing neonate or multiple minor risk factors)

   Minor risk factors: (for your reference) Breastfeeding, use of oxytocin/diazepam peripartum, ethnicity Asian or Native American, Gestational Diabetes, Group B Streptococcus test positive or unknown, poor feeding, birth trauma (cephalohematoma, instrument delivery), male gender, prior sibling with jaundice.

3. Click on the "Phototherapy Treatment Decision Graph," (from Bhutani), to indicate the times and values of bilirubin values measured. Note that there is a display below the graph indicating your cursor position. Also note that the points are automatically displayed on the "Risk Category Nomogram".

4. The "Table of Data and Recommendations" will automatically display suggestions after data is entered. Be sure to click on "Jaundice?" box if jaundice is observed. Click the "Print" button to open a printable window of page with data.

Graphs

Table of Data and Recommendations

Date and Time	Hours of Life	Bilirubin Value	Jaundice?	Phototherapy?	Risk Category	Recommendations	AAP Reference
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References & Credits

1. VK Bhutani, Predictive Ability of a Predischarge Hour-specific Serum Bilirubin for Subsequent Significant Hyperbilirubinemia in Healthy Term and Near-term Newborns
2. AAP Guideline: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
3. Rubaltelli, Transcutaneous Bilirubin Measurement: A Multicenter Evaluation of a New Device
4. www.bilitool.org for inspiration.
5. Dr. Tom Balsbaugh, Director of Family and Community Medicine, University of California, Davis

Please send me feedback! shomirb@shomir.org

last update 02/25/11