As an alternate strategy, you could invest in a transutaneous bilimeter so the midwives can screen infants at home. There are at least two on the market; the Bilichek and the Drager Bilimeter. These would at least give an indication of whether the infant should be brought in for a venous sample.
Jan
Mrs. J. Still,
POCT Manager,
Biochemistry Dept,
Watford General Hospital. 01923-217998.
The views expressed in this message are personal and do not reflect West Herts NHS Hospitals Trust policy.
----- Original Message ----
From: "Hamilton, Jenny" <[log in to unmask]>
To: [log in to unmask]
Sent: Fri, 12 March, 2010 14:11:34
Subject: Neonatal hyperbilirubinaemia
Dear Mailbase
We have been contacted by our Community Midwives regarding their protocol for investigating prolonged jaundice. Apparently they have to take a blood sample at 14 days if the discharged child is still displaying signs of jaundice, but as they are not allowed to take a venous sample, they are taking the sample using the heelprick technique. They are taking the samples into paediatric LiHep tubes and delivering them to the laboratory quickly. However, most of the samples are haemolysed (due to the heelprick method) and so the laboratory is unable to report the direct bilirubin result. They say the only way they can get venous samples taken is to send the child to the paediatricians, who at that stage do not want to know as they only get involved once the conjugated bilirubin has been proved to be elevated and the child requires further investigation. The laboratory uses the Roche Modular assay with the haemolysis index set at 50 for total bilirubin and 25
for direct bilirubin.
Has anyone else encountered this problem and how have you got around it?
Best wishes
Jenny Hamilton
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Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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