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Cpms College of Nursing Assignment ON Bilimeter: Subject: Child Health Nursing DATED:23 JUNE 2021

This document provides instructions for using a bilimeter device to measure bilirubin levels in infants in a non-invasive manner. It describes how to initialize and calibrate the device, take measurements on an infant's forehead or sternum by placing a disposable tip on the skin, and document the results. The document also outlines limitations of transcutaneous bilirubinometry including effects of phototherapy, skin thickness and melanin content. It concludes the device is a desirable way to screen for hyperbilirubinemia without blood sampling.

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Amy Lalringhluani Chhakchhuak
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1K views5 pages

Cpms College of Nursing Assignment ON Bilimeter: Subject: Child Health Nursing DATED:23 JUNE 2021

This document provides instructions for using a bilimeter device to measure bilirubin levels in infants in a non-invasive manner. It describes how to initialize and calibrate the device, take measurements on an infant's forehead or sternum by placing a disposable tip on the skin, and document the results. The document also outlines limitations of transcutaneous bilirubinometry including effects of phototherapy, skin thickness and melanin content. It concludes the device is a desirable way to screen for hyperbilirubinemia without blood sampling.

Uploaded by

Amy Lalringhluani Chhakchhuak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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CPMS COLLEGE OF NURSING

ASSIGNMENT
ON
BILIMETER

SUBJECT: CHILD HEALTH NURSING


DATED:23RD JUNE 2021

SUBMITTED TO:
MAAM ARCHANA DAS
ASSOCIATE PROFESSOR
M.SC. (N) CHILD HEALTH NURSING
CPMS CON

SUBMITTED BY:
BIDYALAXMI NAOREM
ROLL NO: 02
M.SC. (N) 1ST YEAR
CPMS CON
BILIMETER
INTRODUCTION
Bili-meters are devices that measure bilirubin transcutaneous (i.e., without
drawing blood). They work by directing light into the neonate’s skin and then
measuring the intensity of specific wavelengths that return, and using this
information to calculate bilirubin level. In preterm infants, hyperbilirubinemia is
common and can impair the central nervous system. The tests available for
measuring bilirubin is to collect blood from heel pricking which is painful.
Therefore, there is a need to develop a non-invasive device to detect bilirubin
levels.
DEFINITION
Bilirubin is an open chain molecule containing four pyrrole-like rings that forms
during the breakdown of heme. Bilirubin is excreted in urine and bile and can
also be found in low levels in plasma. Eventually, bilirubin is degraded in the
liver to be removed from the body.
PURPOSE
 To analyze total serum bilirubin (TSB) in a noninvasive and pain-free
manner.

PROCEDURE TESTING
Initializing the Unit: Install a fully charged battery pack into the battery
compartment of the unit. Press and release either the F1 (blue) or F2
(gray) button on the front of the Bili Chek unit to turn the device on. The
device will perform a self-test, momentarily displaying all LCD
indicators. When the self-test is complete, the home screen will be
visible, displaying the last measurement, time and date (or an error code
message, if applicable).
The first time the Bili Chek is used, it is necessary to enter the set-up
mode and program the display settings before proceeding. Refer to the
User Instruction Manual for complete set up instructions.
The Bili Chek does not have an off switch, and will automatically turn off
if is idle for a 60 seconds.
CALIBRATION
Remove a new BiliCal disposable tip from its foil pouch and apply it to
the optical sensor on the Bili Chek handheld device before each use.
Firmly press the BiliCal on the Bili Chek handheld device to ensure
proper seating of the tip.
With the home screen displayed, press and release the trigger button (the
blue button located on the hand grip) to start calibration.
Three dashes (---) will flash in the display window, and the Measurement
Status Indicator (MSI) will be amber if the BiliCal is properly seated,
indicating that the device is ready to calibrate. (If the BiliCal is not
properly seated, the mSI will be red, and an EO1 error message will be
displayed).
Press and release the trigger button again. The dashed lines will stop
flashing, indicating that the Bili Chek is calibrating.
The MSI will be amber colored and a beep will be heard. The display
window will read (005) to indicate that the calibration was completed
successfully. If there is a failure in calibration, and error message will be
displayed, and one will be unable to proceed with the testing. Refer to the
trouble shooting section of the User Instruction Manual.
PERFORMING PATIENT TEST
 After performing the calibration, pull on the BiliCal tab and peel away
the protective covering from the disposable tip and discard.
 Press and release the trigger button. The device is now activated and
ready to take a measurement (005) will be displayed and blinking.
 Gently press the bilical against the infant’s forehead or sternum. The MSI
on the display will change from amber to green, and the 005 will stop
blinking when the proper pressure is applied.
 Hold the Bili Chek handheld device steady until the measurement is
complete (for about 1-3 seconds). The device will beep if the audible
alarm is enabled.
 Perform a series of five (5) measurements by lifting and replacing the Bili
Cal on the center of the infant’s forehead of sternum. Press and release
the trigger button before each measurement. The current measurement
will be indicated on the display (005…003...001).
 Upon completion of the five (5) measurements, a final beep will sound,
and the test result will be displayed along with the current time and date.
Remove and discard the disposable tip.
 Place the blue protective tip cover onto the Bili Chek handheld device.
 The Bili Chek will turn off automatically.
DOCUMENTING RESULT
 Document the infant test result, date, and time in the infant’s chart, on
Jaundice Teaching Sheet and the electronic Newborn Discharge
Information Sheet.
 Notify the infant’s physician.
 Obtain follow-up measurements in accordance with physician orders.
 QA documentation Procedures: The BiliChek performs internal
calibration controls prior to each patient test. The device will not permit
testing to occur if the calibration does not meet the control specifications.
In order to document completion of the calibration prior to each test, a
“Quality Documentation Record” should be completed (refer to Appendix
A). An individual record should be maintained for each BiliChek device,
and tracked by serial number.
CLEANING AND MAINTENANCE
 Cavicide wipes are used to clean the Bili Chek after each use.
 To clean, wipe the Bili Chek with a Cavicide wipe, being sure to clean
the display window carefully.
 Do not immerse the Bili Chek in water or any liquid. If liquids spill onto
the unit, wipe immediately with a cloth and let unit dry before use.
 Do not attempt to clean and/or reuse the BiliCal Disposable Tip.
DURING PHOTOTHERAPY USE
 Prior to the initiation of Phototherapy, the measurement site on the
infant’s forehead or sternum must be covered with a photo-opaque patch
material. The patch must remain in place throughout phototherapy.
 To take a measurement during phototherapy: Turn off the phototherapy
lights (fiber optic or overhead), remove the photo- opaque patch, perform
the Bili Chek measurement, replace the photo- opaque patch, resume
phototherapy as ordered.
 Clinical studies indicate that up to 48 hours may be required before the
skin treated by phototherapy returns to the bilirubin level of an unexposed
site; therefore measurements from an unprotected site are not reliable.

LIMITATIONS OF TRANSCUTANEOUS BILIRUBINOMETERS


 Transcutaneous Bilirubinometers can be affected by a variety of factors,
such as phototherapy and exposure to sunlight.
 Dermal thickness and the melanin content of the skin.
• Limit the use of Tc. B. to infants <10 days old.
• A clean, disposable tip is required for each measurement.
CONCLUSION
 Non-invasive Tc. B. measurements are a desirable modality since it is a
quick, non-invasive technique to screen for hyperbilirubinemia.
 As a substitute to TSB for inspecting jaundiced neonates.
 It reduces invasive blood sampling and permits a time effective and
reasonably precise estimation of bilirubin levels.
 None of the actual guidelines suggests the use of Tc. B. measurements as
an indication for starting phototherapy.
POINTS TO REMEMBER:
The Bili Chek Analyzer has been clinically proven to be accurate in
patients within the following parameters:
• Gestational Age of 27 to 42 weeks
• Postnatal Age of 0 to 20 days
• Infant Weight of 950 to 4995 grams
The Bili- Chek should not be used in the following situations:
• Following exchange transfusion
• If the measurement site on the forehead contains excessive bruising,
birthmarks, hematomas, or excessive hairiness due to erroneous results.
• If unable to use the forehead, it is recommended to use the sternum as
an alternative measurement site.

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