# Phototherapy

## Overview

This module describes how to administer phototherapy to treat neonatal jaundice.

## Indications

## Contraindications

## Patient information and consent

### How do I explain this procedure?

“Your baby has jaundice, a common condition of newborns that requires a once-off treatment, and has no long-term effects. Jaundice means the body is producing too much of a certain chemical causing the skin to turn yellow. When we place your baby under special lights, it breaks down this yellow pigment in the skin so that the baby can get rid of it through their urine and stool.”

### What can my patient expect?

“Your baby will be in the incubator or the cot with a lamp over it. We will protect the eyes with eye pads. We will be taking blood every 12 hours from your baby's heel or arm to monitor the level of the chemical. Once it has dropped to a safe level we can remove your baby from under the lights. It may take a day or up to several days. The therapy is not painful for the baby, but they might be more thirsty and need to drink more.”

### What is my patient’s role?

“Please keep your baby undressed and the nappy open and underneath the baby while he/she is under the lights as the skin needs to be exposed to the light for it to work. The eye pads must remain on while the baby is under the lights but you can remove them while feeding your baby. Please inform a nurse or a doctor if you notice loose stools, a rash, the baby is too hot or too cold, dehydration or anything else that worries you about the baby.”

## Preparation

Familiarise yourself with the lights that are available in the nursery of your institution and check that these are

in working order

in working order

Fluorescent tubes should be changed at regular intervals as specified by the manufacturer. Generally these are 1000 hours for fluorescent tubes, 800 hours for halogen bulbs and 3000 hours for LED lights. The tube is covered by a plexiglass shield.

. If you have a radiometer, confirm

adequate

adequate

It should be more than 8-9 µW/Cm2/nm.

irradiance.

###

### Documentation

### Equipment

## Site & Positioning

Position

Position

Check the manufacturer’s instructions if you are unsure.

the tubes as close as possible to the baby’s skin without causing hyperthermia. In an open bassinet, this could be as close as 10 cm, otherwise 20 cm, but no more than 40 cm away from the infant. A combination of two banks can be used simultaneously for intensive phototherapy.

## Procedure

Follow medical asepsis without gloves.

## Troubleshooting

I do not have a phototherapy or exchange transfusion chart.

The nursery and paediatric ward usually has one. If not, search for a local guideline online or request one from a senior.

The TSB is continuing to rise or remains the same, but is still below the exchange transfusion line.

If capillary blood sampling was used, take venous blood to confirm, but place the neonate under double lights in the interim. If the TSB continues to rise, monitor closely to ensure it does not reach exchange transfusion levels. Consult a senior if unsure.

## Risks

## References