Algorithm for the Management of Jaundice in the Newborn Nursery
Algorithm for the Management of Jaundice in the Newborn Nursery Neonatal Jaundice Neonatal Jaundice
«Flowchart»

Newborn infant

Newborn infant

Newborn infant

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Assess for jaundice every 8-12 hr

Assess for jaundice every 8-12 hr

Assess for jaundice every 8-12 hr

Is age <24 hr or does jaundice by visual assessment or TcB appear severe enough to require TSB or TcB?

Is age <24 hr or does jaundice by visual assessment or TcB appear severe enough to require TSB or TcB?

Is age <24 hr or does jaundice by visual assessment or TcB appear severe enough to require TSB or TcB?

Measure TSB or TcB and interpret by age in hours

Measure TSB or TcB and interpret by age in hours

Measure TSB or TcB and interpret by age in hours


    Evaluate cause
    Treat if criteria for treatment met
    Repeat TSB in 4-24 hr

    Evaluate cause
    Treat if criteria for treatment met
    Repeat TSB in 4-24 hr

    Evaluate cause
    Treat if criteria for treatment met
    Repeat TSB in 4-24 hr

Evaluate cause
Treat if criteria for treatment met
Repeat TSB in 4-24 hr

Evaluate TSB level, gestational age & hours of life. Treat if criteria for treatment met

Evaluate TSB level, gestational age & hours of life. Treat if criteria for treatment met

Evaluate TSB level, gestational age & hours of life. Treat if criteria for treatment met

Follow up by 48-120 hours of age, exact timing deps upon age in hours and presence of risk factors

Follow up by 48-120 hours of age, exact timing deps upon age in hours and presence of risk factors

Follow up by 48-120 hours of age, exact timing deps upon age in hours and presence of risk factors

Discharge and follow-up at physician discretion*

Discharge and follow-up at physician discretion*

Discharge and follow-up at physician discretion*

* *

Discharge with planned follow-up*

Discharge with planned follow-up*

Discharge with planned follow-up*

* *

Measure TSB or TcB if not already done, assure plan for follow-up and/or management* according to bilirubin level

Measure TSB or TcB if not already done, assure plan for follow-up and/or management* according to bilirubin level

Measure TSB or TcB if not already done, assure plan for follow-up and/or management* according to bilirubin level

* *

Is jaundice present?

Is jaundice present?

Is jaundice present?

Yes

Yes

Yes

No

No

No

Yes

Yes

Yes

No

No

No

Is TSB >95th precentile?

Is TSB >95th precentile?

Is TSB >95th precentile?

Yes

Yes

Yes

No

No

No

Has TcB or TSB been measured?

Has TcB or TSB been measured?

Has TcB or TSB been measured?

Yes

Yes

Yes

No

No

No

Is newborn ready for discharge?

Is newborn ready for discharge?

Is newborn ready for discharge?

Yes

Yes

Yes

No

No

No

Any risk factors or infant <72 hr old?

Any risk factors or infant <72 hr old?

Any risk factors or infant <72 hr old?

Yes

Yes

Yes

No

No

No

Ant repeat TSB drawn?

Ant repeat TSB drawn?

Ant repeat TSB drawn?

Yes

Yes

Yes

No

No

No

Is TSB >95th percentile?

Is TSB >95th percentile?

Is TSB >95th percentile?

Yes

Yes

Yes

No

No

No

Is follow-up assured?

Is follow-up assured?

Is follow-up assured?

Yes

Yes

Yes

No

No

No

* Provide information and written guidelines about jaundice to parents of all newborns at discharge.

* Provide information and written guidelines about jaundice to parents of all newborns at discharge.

* Provide information and written guidelines about jaundice to parents of all newborns at discharge.

*

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