Neonatal Hyperbilirubinemia: Recommendations for Diagnosis and Management in the Emergency Department

Points & Pearls Excerpt

• Using age in hours and a TSB level, the AAP recommends using the hour-specific nomogram (see Figure 3, page 5) to determine appropriate management and follow-up to reduce the risk of severe hyperbilirubinemia.
• The presence of hyperbilirubinemia risk factors is used to help interpret the results of the hour-specific nomogram. Hyperbilirubinemia risk factors include:
  • A newborn nursery predischarge TSB in the high-risk zone
  • Jaundice observed in the first 24 hours
  • ABO incompatibility or other known hemolytic disease
  • Gestational age 35 to 36 weeks