This resource is a part of a seven-module curriculum intended to provide teaching faculty caring for well newborns with accessible, approachable, easily delivered, hands-on tools for bedside teaching in the newborn nursery. The seven modules are linked. This module focuses on newborn jaundice. Jaundice is an exceedingly common problem in the early newborn period, yet the approach to the physical examination and evaluation of jaundiced infants will vary depending on infant age, condition, and risk factors. The appropriate management of neonatal jaundice depends on one’s ability to distinguish infants at risk for developing jaundice from those at risk for developing neurotoxicity from jaundice. In addition, the physician must be able to recognize the uses and limitations of published guidelines and to correctly interpret findings on the physical examination. This module is designed to review the clinically relevant aspects of neonatal hyperbilirubinemia that presents in the first days of life and then translate that knowledge into informed management of a jaundiced infant. It has been used in the newborn nursery setting to stimulate thought and discussion about jaundice. It has primarily been used by attending physicians who are teaching pediatric residents and medical students, but could also be used by a senior resident who is functioning in a supervisory or teaching role. Medical students and resident physicians have given very positive feedback about the material presented, and attending physicians have found it easy to use. Third-year medical students and pediatric residents were evaluated using a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Results are as follows: “Presentation was well-organized and presented clearly.” (4.57 average); “Audiovisual aids were helpful.” (4.43); “Topic was important and useful.” (4.71); “Presentation was appropriate for my level of training.” (4.71); “Presenter achieved stated objectives.” (4.71); “Overall, teaching was effective.” (4.43); and “This presentation should be continued.” (4.71).
By the end of this module, the learner will be able to:
- List risk factors for hyperbilirubinemia and for neurotoxicity associated with hyperbilirubinemia.
- Demonstrate the use the Bhutani nomogram.
- Identify physical findings associated with hyperbilirubinemia.
- Demonstrate application of this knowledge to the evaluation and management of a jaundiced infant.
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- Numbers Needed to Treat With Phototherapy According to American Academy of Pediatrics Guidelines. Pediatrics 2009;123;1352. http://dx.doi.org/10.1542/peds.2008-1635
- Total Serum Bilirubin Exceeding Exchange Transfusion Thresholds in the Setting of Universal Screening J Pediatr. 2011;160(5):796-800. http://dx.doi.org/10.1016/j.jpeds.2011.09.063
© 2012 Aby et al.
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Aby J, Schiller J, Burrows H, Goodson S, Phillipi C. Newborn nursery teaching attending guide: module 6. Newborn jaundice. MedEdPORTAL. 2012;8:9247. https:/
doi. org/ 10. 15766/ mep_ 2374- 8265. 9247