Newborn Orders - Saskatoon Health Region Page 2
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3Algorithm for Total Serum Bilirubin (TSB) Results
Adapted from: Barrington K and Sankaran K. Paediatr Child Health 2007; (12)Suppl B):1B-12B
Step 1: Use TSB and Figure 1 below to determine need for phototherapy
Step 2: Use TSB and Figure 2 below to determine bilirubin zone
Figure 2: Nomogram for evaluation of screening TSB in term and late preterm infants,
Figure 1: Intensive Phototherapy Guidelines for infants of 35 or more weeks’ gestation
according to the TSB concentration obtained at a known postnatal age in hours.
Note: Charts above this line are not for use with TcB. TSB and TcB nomograms differ. Correct nomograms must be used.
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Step 3: If treatment not required, use charts below to determine follow-up based on bilirubin zone and gestational age
6
Baby greater than / equal to 38 weeks gestation
Baby 35 – 37
/
weeks gestation
7
DAT Negative
DAT Positive or Unknown
DAT Negative
DAT Positive or Unknown
Response to
Response to
Zone
Zone
Response to results
Zone
Zone
Response to results
results
results
Low
Routine Care
Low
Routine Care
Low
Routine Care
Low
Routine Care
Low
Low
Low
Low
Follow up within 24 hours.
Routine Care
Routine Care
Routine Care
Intermediate
Intermediate
Intermediate
Intermediate
DAT advised.
High
High
High
Follow-up within
High
Follow up within 24 hours.
Routine Care
Follow up within 24 hours
Intermediate
Intermediate
Intermediate
24-48 hours
Intermediate
DAT advised.
Follow up within
Follow up within 24
Follow up within 24
Phototherapy. DAT
High
High
High
High
24 hours
hours. DAT advised.
hours
advised.
Figure 3: Charts to determine need or further testing and follow-up based on TSB zone
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