a nurse is planning care for a newborn who requires phototherapy for hyperbilirubinemia This is a topic that many people are looking for. militaria-agent.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, militaria-agent.com would like to introduce to you How to use phototherapy. Following along are instructions in the video below:
Hi. Im andrea and im a nicu nurse. Part of my job at at ge is to work with customers around the country on how to understand and our products to treat and help take care of their babies.
We wanted to do this special series for you on photo therapy. Because we get a lot of questions on it a lot. And theres so much misinformation and confusion on photo therapy that we wanted to bring this series of videos to help you use photo therapy to treat your babies.
So to kick off the photo therapy series. I wanted to quickly share with you the key things that you need to know to use photo therapy. Im not sure if you all notice.
But jaundice is very common and affects three out of five babies born thats 60 of babies born. Its so common and in one study published in pediatrics. It showed that 35 of early readmissions of apparently healthy.
Newborns or because of jaundice and then almost all preterm infants. Less than 35 weeks gestational age. Have elevated total serum or plasma.
Bilirubin levels. So. Even.
Though. Jaundice is fairly common and the treatment. Looks as simple as using a light.
You cant imagine how many questions we get from customers on how to use our billy soft or our overhead photo therapy properly even when i walk into some units. Ill see a baby with four phototherapy lights on them. Which is not necessary so first things first theres two major types of jaundice in direct indirect.
And if it is indirect or non conjugated jaundice. Then it can be treated with photo therapy or light therapy. Indirect.
Jaundice is the more common one. And thats what were going to talk about today back in 2004. The american academy of pediatrics.
The aap came out with the clinical practice guidelines management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation her the aap guidelines. Effective phototherapy is an equation of the exposed surface area coverage. Light.
Wavelength b. Irradiance or intensity of the light.
An equally important is the duration of exposure to photo therapy to decrease the bilirubin to safe levels. These four things help to make up the effective overall dose of photo therapy. So the most important factor is irradiance.
The light intensity level expressed in microwatts per. Centimeter. Squared per nanometer photo therapy is delivered within the spectral range where the bilirubin molecules maximum absorption of light occurs between 450 and 416 nanometers now intensive photo therapy from the aap guidelines.
Says that intensive. Photo therapy. Implies.
Irradiance in the blue green spectrum wavelengths of approximately 430 to 490 nanometers. Our billy soft and giraffe blue spot. And regular giraffe spot.
Photo therapy. Meets. These specifications under certain conditions.
The more body surface area exposed to light. The better. So you might hear of double photo therapy.
And this is where it can apply the right way to do double photo therapy is putting an intensive. Light underneath. The baby and an additional intensive light overhead to cover the complete body surface area of the baby from head to toe.
So the wrong application of double photo therapy is thinking that two plus two equals four so for example. If you use two overhead lights that both have inner radiance of 20 micro watts. Per centimeter squared per knee.
And you may see a nominal increase in the irradiance level. But you will not see it increase to 40 microwatts per centimeter squared per nanometer. So lets talk about duration of phototherapy exposure.
Generally you dont need to interrupt photo therapy for clinical care or family bonding. And what most people dont realize about photo therapy. Is that you need to check the dose of your photo.
Therapy. Device. Utilizing the meter designed for that specific medical device.
Validated for use by the manufacturer. So for example.
If you have a ge phototherapy device. Always use the billi blanket meter or if ge should adopt a new meter in the future. It would be validated for use with our devices.
While you are waiting six minutes for it to warm up place the fiber optic. Light pad on a flat surface do not place the fiber optic light pad inside of a billy soft pad cover or billy soft nest at this time use a calibrated billy. Meter that is approved for the billy soft 20.
Im using the approved amita medical. Billy blanket meter to take measurements on the lit side of the pad using the meter placed at points. As shown on the back of the pad.
So take out your billy blanket two meter will check to make sure the batteries work set the on off switch to the on position a zero adjustment is performed automatically when the switch is set to eye or on youll see that cow will be displayed during zero adjustment zero adjustment is performed electronically so no cap is required when zero adjustment is complete the cal message will disappear. Just remember. When youre doing this make sure to keep the meter.
Still do not subject the billy blanket meter to to shocks or vibration especially at the time of zero level adjustment. Inaccurate readings may result youll need to install new batteries. If the display window is blank or a battery mark will appear above the measured value if you continue to use the instrument.
The mark will start to blink and measurement will no longer be possible to quickly measure the irradiance of the billy soft set the hold run switch to the run position. Its this round button here the billy blanket meter 2. Now performs continuous irradiance measurements to freeze the display and irradiance reading press.
The hold run switch push button to set it to its inward hold position this freezes the display reading at the current spectral irradiance. Level so for the small billy soft 20. Pad.
If i take the readings in the middle c. And d. And take the average of c.
And d. If it is greater than or equal to 60 micro watts. Per centimeter squared per nanometer.
Then it works. If you get less than 60. Youll want to do a full check you check all six points and you take the average.
If it is less than or equal to 39. Then its time to replace the led in the. Box if you have the large billy soft 20.
Pad. To do the quick reading check.
The center row d. E and f. And take the average of it.
If it is greater than or equal to 40. Then its okay to use if its less than 40. Then do the full nine point check.
If the 9 point checks. Result is less than or equal to 27 then it is time to replace the led now remember the billy soft. 20.
Unit should work fine for over 50000. Hours of use. This is an improvement over the.
Old billy soft. Phototherapy system which would need replacement after. 8000.
To 10000. Hours music focus. The therapeutic light.
Such that the shade is 38 centimeters. Which is 15 inches from the bed surface or you could measure the spot diameter to be 35 point five centimeters. Which is 14 inches.
Allow the giraffe blue spot pt light to warm up for five minutes from my experience. This is when i would go look for the billy meter. This is probably how long it takes to find one using a calibrated billy blanket light meter to measure the light at the five light measurement points.
And calculate their average the way to remember. It is take their reading at the center of the circle. Now imagine that circle is divided into four quarters measure.
The center of each quarter. Confirm that the average is at least 27 microwatts per centimeter squared per nanometer. If not have your biomed take a look at it to see if the led bulb or something else needs to be replaced divide the lowest reading by the highest reading if the led light is.
Functioning. Properly the result should be greater than. 04 if the result is not greater than 04.
Contact service. So if you found this helpful stay tuned for the next episode of our phototherapy series music. .
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