Book
Neonatal Jaundice (Newborn Jaundice)
- Exchange Transfusion
Objective:
To remove excess bilirubin and replace damaged red blood cells
covered with antibodies.
Blood Requirements:
- Fresh whole blood (not packed red cells)
- Free from infectious diseases
- Less than 48 hours old
- Compatible with the mother’s blood
Post-Exchange Transfusion Procedures
- Repeat the previous steps until the required blood volume is completely exchanged.
- Periodically mix the blood to prevent red blood cell sedimentation.
- Record every step of blood withdrawal or transfusion, including the exact time and the infant’s vital signs and oxygen concentration in the exchange transfusion chart.
- Notify the doctor after every 100 ml of blood exchange.
- Immediately stop the transfusion if any signs of a blood reaction appear.
- Dispose of waste materials in designated trash bins and safety containers.
- Disinfect the heating device after turning it off.
- Perform routine handwashing after removing gloves.
- Document the procedure and all observations in the nursing records.
Post-Exchange Blood Tests & Monitoring
- Immediately collect a blood sample and send it to the laboratory for:
- Bilirubin level test
- Complete blood count (CBC)
- Calcium, sodium, and potassium levels
- Place the newborn under phototherapy.
- Monitor blood glucose levels every 4-6 hours.
- Measure bilirubin levels every 6 hours.
- Measure abdominal circumference every 6 hours for 24 hours.
- Observe for any signs of bleeding or blood in stool.
- Record all observations in the newborn’s medical file.
Responsible Personnel:
- Nursing Staff
