Hours of Life Calculator
Neonatal Jaundice Chart
35 to 38 Weeks
No Neurotoxicity โ โฅ38 Weeks
| Hours | PT | ET |
|---|
Neurotoxicity Risk Factors
- Isoimmune haemolytic disease, G6PD deficiency, other haemolytic conditions
- Sepsis
- Any significant clinical instability in previous 24 hours
- Albumin < 30g/L (if measured)
Source: Paediatric Protocols 5th Edition | Unit: μmol/L.
Neonatal Jaundice Chart for Preterm
23 to 34 Weeks
Gestational Age at Birth:
| Age | PT | ET |
|---|
๐ Key Updates: Paediatric Protocols 5th Edition
1
New Classification System
Stratified by Gestational Age (weeks) + Neurotoxicity Risk Factors. The Low/Moderate/High risk categories have been replaced.
2
Updated Treatment Thresholds
Several phototherapy and exchange transfusion thresholds are higher than the previous edition.
3
Extended Time Axis
The management charts now include infants > 96 hours of life.
๐ Clinical Management Notes
Weight Loss: Infants with weight loss > 7% should be referred.
Transcutaneous Bilirubinometer (TcB) Rules
- TSB Requirement: Measure TSB if TcB exceeds or is within 50ฮผmol/l (3mg/dL) of the phototherapy threshold, or if TcB is โฅ 256ฮผmol/l (15mg/dL).
- Phototherapy: TcB is NOT to be used for infants currently on phototherapy.
- Age Limit: Not recommended for infants less than 24 hours of life.
- Post-Photo: TcB can be used for monitoring once it has been 24 hours since the cessation of phototherapy.
๐ Prolonged Jaundice
Visible jaundice persisting beyond 14 days (Term>35W+6D) or 21 days (Preterm).
๐จ Examination Red Flags
- Growth failure
- Jaundice, Pallor
- High-pitched cry, temperature instability, lethargy, dehydration
- Neurological: Muscle tone abnormalities, hyperexcitable reflexes (BIND)
- Hepatosplenomegaly
๐งช Investigations & Referral
REFER IF: Direct (conjugated) bilirubin > 25 ฮผmol/l OR > 20% of total bilirubin.
- Serum bilirubin (total, direct, indirect), LFT (Total Protein, Albumin, ALT, AST, ALP)
- FBC, retic count
- Thyroid Function Test
- Urine FEME, Urine C&S