https://padlet.com/shannonisennock/v4xhx5aqlccm5k09 en-us 2023-06-19 19:17:37 UTC 2026-01-15 19:19:37 UTC hello@padlet.com shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627360210 2023-06-19 19:21:49 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627360210 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627360495 2023-06-19 19:22:18 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627360495 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627361709 If more than 1 bilirubin measure is available, the rate of rise can be calculated to risk stratify. A rapid rate of rise (>0.3 mg/dL per hour in the first 24 hours or >0.2 mg/dL per hour thereafter) are high risk for subsequent development of hyperbilirubinemia. 

- Consider phototherapy even if not at threshold
- Obtain DAT if not previously done]]> 2023-06-19 19:25:26 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627361709 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627362439 Use of IV fluids is not recommended unless there is evidence of dehydration that cannot be corrected enterally or if the serum bilirubin exceeds the escalation of care threshold.]]> 2023-06-19 19:27:26 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627362439 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627363069 - Serum bilirubin should be re-checked within 12 hours of starting phototherapy.

- Discontinuing phototherapy is an option when serum bilirubin has decreased by at least 2 mg/dL below the threshold at the initiation of phototherapy.

- Obtain a level at the time of discontinuing phototherapy.

- Follow-up
      - Obtain serum bilirubin within 6 hours of discontinuation for DAT positive infants, infants who were started on phototherapy within 48 hours of birth, concern for another type of hemolytic process.
     - Obtain serum bilirubin within 24 hours of discontinuation for all other infants.]]> 2023-06-19 19:28:56 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627363069 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627364579 For infants requiring phototherapy, measure the hemoglobin, hematocrit, or complete blood count to assess for the presence of anemia and to provide a baseline in case subsequent anemia develops.

Obtain a DAT in infants whose mother had a positive antibody screen or whose mother is blood group O regardless of Rh(D) status or whose mother is Rh(D)-. 

For serum bilirubin increasing despite intensive phototherapy, consider Hematology consultation for work-up for other causes of hemolysis. ]]> 2023-06-19 19:31:59 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627364579 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627368386 - STAT Labs: Total and direct serum bilirubin, CBC, CMP, and type and crossmatch
- Trend total serum bilirubin q2h
- Begin IV hydration, continue PO hydration
- Consider IVIg
- Consult NICU for transfer while continuing phototherapy]]> 2023-06-19 19:40:30 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627368386 shannonisennock https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627368876 Infants with signs of intermediate or advanced stages of acute bilirubin encephalopathy including hypertonia, arching, retrocollis, opisthotonos, highpitched cry, recurrent apnea, or serum bilirubin above the exchange transfusion threshold.]]> 2023-06-19 19:41:48 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2627368876 awalke77 https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2652305128 2023-07-27 22:14:04 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2652305128 awalke77 https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2652307920 2023-07-27 22:28:03 UTC https://padlet.com/shannonisennock/v4xhx5aqlccm5k09/wish/2652307920