Transcutaneous Bilirubinometer
Device Overview
A transcutaneous bilirubinometer is a non-invasive optical device used to measure bilirubin levels in newborns by analyzing skin color, providing rapid screening for jaundice without blood sampling.
Operating Principles
Technology Fundamentals
- Spectrophotometric analysis using multiple wavelengths
- Light transmission through dermal layers
- Measurement of light reflection and absorption
- Digital processing of optical signals
- Correlation with serum bilirubin levels
Measurement Mechanism
- Xenon flash lamp emission
- Dual wavelength analysis (450-550 nm)
- Compensation for melanin and hemoglobin
- Automatic calibration systems
- Digital result display in mg/dL or μmol/L
Clinical Applications
Primary Uses
- Screening for neonatal jaundice
- Monitoring bilirubin trends
- Decision support for phototherapy
- Post-phototherapy assessment
- Follow-up care management
Measurement Protocol
- Clean probe tip before each use
- Multiple measurements (minimum 3)
- Standard measurement sites:
- Mid-sternum area
- Forehead (2.5 cm above eyebrows)
- Avoid areas with:
- Bruising or bleeding
- Birthmarks or hemangiomas
- Previous phototherapy exposure
Technical Specifications
Device Parameters
- Measurement range: 0-20 mg/dL
- Resolution: 0.1 mg/dL
- Accuracy: ±1.5 mg/dL
- Measurement time: 2-3 seconds
- Memory capacity: 40-100 readings
Maintenance Requirements
- Daily calibration check
- Regular probe cleaning
- Battery level monitoring
- Annual manufacturer calibration
- Software updates as recommended
Clinical Considerations
Advantages
- Non-invasive measurement
- Immediate results
- Reduced need for blood sampling
- Portable and user-friendly
- Cost-effective screening
Limitations
- Accuracy affected by:
- Skin pigmentation
- Gestational age
- Birth weight
- Phototherapy history
- Correlation variations with serum levels
- Need for confirmatory blood tests in high-risk cases
Quality Assurance
Quality Control Measures
- Regular calibration verification
- Standard measurement protocols
- Documentation of readings
- Correlation studies with serum values
- Staff training and competency assessment
Troubleshooting Guide
- Error code interpretation
- Battery replacement procedures
- Calibration error resolution
- Cleaning and maintenance protocols
- Technical support contact information
Decision Support
Risk Assessment
- Age-specific nomograms
- Risk factor evaluation
- Treatment threshold determination
- Follow-up scheduling
Documentation Requirements
- Measurement time and date
- Measurement site
- Number of readings
- Average value calculation
- Clinical correlation notes
