Hyperbilirubinemia Web Conference April 26, 2017 https://join

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Presentation transcript:

Hyperbilirubinemia Web Conference April 26, 2017 https://join Hyperbilirubinemia Web Conference April 26, 2017 https://join.me/TNMCJoinMe1 Dial In: 1-866-906-9330 Participant Code: 6970483#

Introductions

General Information Count the Kicks Any stillbirths with decrease movement? Are mothers getting the brochures? Data Collection NICU data collection ON HOLD Did you submit data on: 2016 cesarean delivery statistics? Safe sleep?

Aim: Prevent Kernicterus

Intervention: Evidence-based Practices

TSB or TcB if any jaundice noted visually (AAP, Keren) If no visible jaundice, unlikely to develop hyperbilirubinemia Visual assessment not accurate for determining severity of hyperbilirubinemia AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1),297-316. DOI: 10.1542/peds.114.1.297. Keren, R., Luan, X., Friedman, S., Saddlemire, S., Cnaan, A., & Bhutani, V. K. (2008). A comparison of alternative risk-assessment strategies for predicting significant neonatal hyperbilirubinemia in term and near-term infants. Pediatrics, 121(1), e170-9.

Universal predischarge bilirubin screening-TSB or TcB(Maisels) Use of clinical risk factors and predischarge bili to predict risk of hyperbilirubinemia (Maisels) Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1),297-316. DOI: 10.1542/peds.114.1.297.

Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

Use hour-specific nomogram to interpret bili (Maisels 2009, AAP 2004) Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329 AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1),297-316. DOI: 10.1542/peds.114.1.297.

Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

Written and verbal info to parents at discharge explaining jaundice and need to monitor for (AAP, 2004) AAP (2004). Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1),297-316. DOI: 10.1542/peds.114.1.297.

Recommendations for Management and Follow-up

Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

Maisels, M. J. , Bhutani, V. k. , Bogen, D. , Newman, T. B. , Start, A Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

Recommendations for Management and Follow-up Maisels, M.J., Bhutani, V.k., Bogen, D., Newman, T.B., Start, A.R., & Watchko, J.F. (2009).Hyperbilirubinemia in te newborn infant ≥ 35 weeks gestation: An update with clarifications. Pediatrics, 124(4), 1193-1198. DOI:10.1542/peds.2009-0329

Considerations for Timing of TcB/TSH LOS varies Risk of omission Coordinate with newborn screen

Subcommittee on Hyperbilirubinemia, Pediatrics 2004;114:297-316 Guidelines for phototherapy in hospitalized infants of 35 or more weeks' gestation Subcommittee on Hyperbilirubinemia, Pediatrics 2004;114:297-316 Copyright ©2004 American Academy of Pediatrics

TSB or TcB if any jaundice noted visually (AAP, Keren) SUMMARY TSB or TcB if any jaundice noted visually (AAP, Keren) Use of clinical risk factors and predischarge bili to predict risk of hyperbilirubinemia (Maisels) Universal predischarge bilirubin screening-TSB or TcB(Maisels) Use hour-specific nomogram to interpret bili (Maisels 2009, AAP 2004) Written and verbal info to parents at discharge explaining jaundice and need to monitor for (AAP, 2004)

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