Kathy asks about an instrument for measuring bilirubin levels by placing
something on the baby's abdomen.
There are hand-held bilirubinometers which give an indirect and approximate
measure of bili levels, calculated with the help of optics.  Don't ask me more,
I am hazy on the details, despite having used this instrument on my ward for
over 10 years, and we still use it many times each day.
We use it to determine whether a blood test is necessary, if we think a baby
looks jaundiced.  If the transcutaneous measure indicates a level close to
treatment threshhold, we do a heel stick.  It can be placed on the forehead or
the sternum.  It emits a sharp flash of light as it does the measurement and we
do it on the sternum to avoid flashing the light near baby's eyes.
It can only be used reliably on light-skinned babies.
Rachel Myr
Kristiansand, Norway

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