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MDpocket Neonatal Bili Wheel Neonatal Bili Wheel

Neonatal Bili Wheel

Use this wheel to guide therapy for neonates with hyperbilirubinemia. There are 6 circles for providers to categorize neonates of a certain gestational age in the treatment of hyperbilirubinemia including those infants who have hemolytic disease of the newborn such as RH disease, ABO or other blood group incompatibility with coombs positive status, presence of sepsis, hypoxemia, acidosis, or low albumin level of ≤ 2.5mg/dL.

Bili Wheel Circles 

1. Orange Circle: Select the gestational age of the infant and determine the healthy/sick status as defined above.
2. Yellow Semi-Circle: Select the weight in kilograms for the infant that corresponds to the Orange Circle selection.
3. Light Green Circle: This is the infant's age in hours from birth, at which their serum bili was drawn.
4. Dark Green Circle: This is the bili level range based on the infant's gestational age, and age in days. 
5. Teal Circle: This is the phototherapy zone for corresponding bili levels in the yellow circle. Please remember these are not absolute values for phototherapy. Recommendations based on personal experience, guidelines, and references.
6. Blue (outermost) Circle: Serum bili level at which exchange transfusion may be considered. Please note that exchange levels serum bilirubin for 500 grams to 1500 grams (both healthy and sick) infants are "variable" and should be considered on an individual basis.

Note:Bili levels are measured in mg/dL.
Abbreviations:
W = gestational weeks, G = grams, kg = kilograms, Bili = bilirubin in mg/dL, P = phototherapy, ET = exchange transfusion 


Authors

Dr. Morarji Peesay, MD. FAAP, and Corazon Papageorgopoulos, BSN, RN

References

1) AAP practice Parameter: Pediatrics 1994:(4):558-565. 
2) Smith JR, Donze A, Schuller L. An evidence-based review of hyperbilirubinemia in the late preterm infant, with implications for practice: Neonatal Netw. Nov-Dec 2007. 
3)Dennery PA, Seidman DS, Stevenson DK. Neonatal Hyperbilirubinemia. N Engl J Med. Feb. 22, 2001.
4) [Best Evidence] Jangaard KA, Doods L. Outcome in a population of healthy term and near term with serum bilirubin levels. Pediatrics. Jul 2008: 122 (1).
5) Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a pre-discharge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near term newborns. Pediatrics 1999; 103 (1):6-14.
6) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004: 114 (1):297 - 316.
7) Management of Jaundice and Prevention of Severe Neonatal Hyperbilirubinemia in Infants 35 Weeks Gestation Vinod K. Bhutania, b, M. Jeffrey Maiselsc. Ann R. Starke, Giuseppe Buonocoree, for the Expert Committee for Severe Neonatal Hyperbilirubinemia. European Society for Pediatric Research and American Academy of Pediatrics.

 

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4214 4214 6.95
Brand: MDpocket
Product Code: 4214
Availability: In Stock
$6.95


Neonatal Bili Wheel

Use this wheel to guide therapy for neonates with hyperbilirubinemia. There are 6 circles for providers to categorize neonates of a certain gestational age in the treatment of hyperbilirubinemia including those infants who have hemolytic disease of the newborn such as RH disease, ABO or other blood group incompatibility with coombs positive status, presence of sepsis, hypoxemia, acidosis, or low albumin level of ≤ 2.5mg/dL.

Bili Wheel Circles 

1. Orange Circle: Select the gestational age of the infant and determine the healthy/sick status as defined above.
2. Yellow Semi-Circle: Select the weight in kilograms for the infant that corresponds to the Orange Circle selection.
3. Light Green Circle: This is the infant's age in hours from birth, at which their serum bili was drawn.
4. Dark Green Circle: This is the bili level range based on the infant's gestational age, and age in days. 
5. Teal Circle: This is the phototherapy zone for corresponding bili levels in the yellow circle. Please remember these are not absolute values for phototherapy. Recommendations based on personal experience, guidelines, and references.
6. Blue (outermost) Circle: Serum bili level at which exchange transfusion may be considered. Please note that exchange levels serum bilirubin for 500 grams to 1500 grams (both healthy and sick) infants are "variable" and should be considered on an individual basis.

Note:Bili levels are measured in mg/dL.
Abbreviations:
W = gestational weeks, G = grams, kg = kilograms, Bili = bilirubin in mg/dL, P = phototherapy, ET = exchange transfusion 


Authors

Dr. Morarji Peesay, MD. FAAP, and Corazon Papageorgopoulos, BSN, RN

References

1) AAP practice Parameter: Pediatrics 1994:(4):558-565. 
2) Smith JR, Donze A, Schuller L. An evidence-based review of hyperbilirubinemia in the late preterm infant, with implications for practice: Neonatal Netw. Nov-Dec 2007. 
3)Dennery PA, Seidman DS, Stevenson DK. Neonatal Hyperbilirubinemia. N Engl J Med. Feb. 22, 2001.
4) [Best Evidence] Jangaard KA, Doods L. Outcome in a population of healthy term and near term with serum bilirubin levels. Pediatrics. Jul 2008: 122 (1).
5) Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a pre-discharge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near term newborns. Pediatrics 1999; 103 (1):6-14.
6) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004: 114 (1):297 - 316.
7) Management of Jaundice and Prevention of Severe Neonatal Hyperbilirubinemia in Infants 35 Weeks Gestation Vinod K. Bhutania, b, M. Jeffrey Maiselsc. Ann R. Starke, Giuseppe Buonocoree, for the Expert Committee for Severe Neonatal Hyperbilirubinemia. European Society for Pediatric Research and American Academy of Pediatrics.

 

Make sure you get the right reference for you! Click here to see our other medical reference wheels and sets!



Card
Author Dr. Morarji Peesay, MD. FAAP, and Corazon Papageorgopoulos, BSN, RN
Diameter 6.62 inches

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