A-Z
Topics
Latest
A
- Abdominal aortic aneurysm
- Abortion care
- Accident prevention (see unintentional injuries among under-15s)
- Acute coronary syndromes: early management
- Acute coronary syndromes: secondary prevention and rehabilitation
- Acute heart failure
- Acute hospitals (adult inpatient wards), safe staffing for nursing
- Acute hospitals (adult inpatient wards), safe staffing for nursing
- Acute kidney injury
- Acute myocardial infarction (see acute coronary syndromes: early management)
- Acute pancreatitis (see pancreatitis)
- Acute upper gastrointestinal bleeding
- Acutely ill patients in hospital
- ADHD (see attention deficit hyperactivity disorder)
- Adult carers (see supporting adult carers)
- Advanced breast cancer
- Adverse drug reactions (see drug allergy)
- Age-related macular degeneration
- Aggression and violence
- Agoraphobia (see panic disorder)
- Air pollution
- Alcohol-use disorders
- Allergy, drug (see drug allergy)
- Allergy, food (see food allergy in children and young people)
- Allergy, severe reaction (see anaphylaxis)
- Alzheimer's disease (see dementia)
- Amyotrophic lateral sclerosis (see motor neurone disease)
- Anaemia management in people with chronic kidney disease
- Anaphylaxis: assessment and referral after emergency treatment
- Ankylosing spondylitis (see spondyloarthritis)
- Anorexia (see eating disorders)
- Antenatal and postnatal mental health
- Antenatal care for uncomplicated pregnancies
- Antibiotic prescribing for diabetic foot infections (see foot care for people with diabetes)
- Antibiotic prescribing for pneumonia
- Antibiotics for early-onset neonatal infection (see early-onset neonatal infection)
- Antibiotics in respiratory tract and ear infections
- Antimicrobial prescribing for common infections
- Antimicrobial stewardship
- Antimicrobials for bites and stings
- Antimicrobials for bronchiectasis (non-cystic fibrosis)
- Antimicrobials for cellulitis and erysipelas
- Antimicrobials for impetigo
- Antimicrobials for leg ulcer infection
- Antimicrobials for prostatitis
- Antisocial behaviour and conduct disorders in children and young people
- Antisocial personality disorder (see personality disorders)
- Anxiety (see generalised anxiety disorder)
- Aortic aneurysm, abdominal
- Aortic aneurysms
- Arthritis, osteoarthritis
- Arthritis, rheumatoid
- Asthma
- Atopic dermatitis (see eczema)
- Atopic eczema (see eczema)
- Atrial fibrillation
- Attachment difficulties in children and young people
- Attention deficit hyperactivity disorder
- Autism spectrum disorder
- Axial spondyloarthritis (see spondyloarthritis)
- Back pain, low
- Bacterial meningitis and meningococcal septicaemia in under 16s
- Barrett’s oesophagus
- Bed sores (see pressure ulcers)
- Bedwetting in children and young people
- Behaviour change
- Behaviour that challenges and learning disabilities
- Benign prostatic hyperplasia (see lower urinary tract symptoms in men)
- Bipolar disorder
- Bites and stings – antimicrobial prescribing
- Blackouts (see transient loss of consciousness)
- Bladder cancer
- Bladder infection (see urinary tract infections)
- Blood and bone marrow cancers
- Blood and immune system conditions
- Blood poisoning
- Blood pressure, high (see hypertension)
- Blood transfusion
- Body dysmorphic disorder (see obsessive-compulsive disorder)
- Borderline personality disorder (see personality disorders)
- Bowel cancer (see colorectal cancer)
- Bowel cancer prevention (see colonoscopic surveillance)
- Bowel incontinence (see faecal incontinence)
- Brain cancer (see brain tumours and metastases)
- Brain tumours and metastases
- Breast cancer, advanced
- Breast cancer, early and locally advanced
- Breast cancer, familial
- Breast conditions
- Breast milk, donor banks
- Breastfeeding (see maternal and child nutrition)
- Bronchiectasis (non-cystic fibrosis) – antimicrobial prescribing
- Bronchiolitis in children
- Bulimia (see eating disorders)
- Caesarean section
- Cancer of unknown primary origin (see metastatic malignant disease of unknown primary origin)
- Cancer, suspected
- Cannabis-based medicinal products
- Cardiovascular disease prevention
- Cardiovascular disease: identifying and supporting people most at risk of dying early
- Care and support of people growing older with learning disabilities
- Care homes, managing medicines
- Care homes, oral health
- Carers (see supporting adult carers)
- Cataracts
- Catheter-associated UTIs (see urinary tract infections)
- Cellulitis and erysipelas – antimicrobial prescribing
- Cerebral palsy
- Cervical cancer
- Challenging behaviour and learning disabilities
- Changing behaviour
- Chest pain
- Child abuse and neglect
- Child growth, faltering
- Child maltreatment (see child abuse and neglect)
- Childbirth (see fertility, pregnancy and childbirth)
- Children's attachment (see attachment difficulties in children and young people)
- Children's palliative care, for people with life-limiting conditions (see end of life care for people with life-limiting conditions)
- Cholelithiasis, cholecystitis and choledocholithiasis (see gallstone disease)
- Chronic fatigue syndrome myalgic encephalomyelitis
- Chronic heart failure
- Chronic kidney disease
- Chronic kidney disease, anaemia management
- Chronic kidney disease, hyperphosphataemia
- Chronic obstructive pulmonary disease
- Chronic pancreatitis (see pancreatitis)
- Cirrhosis
- Cluster headache (see headaches)
- Cochlear implants (see hearing loss)
- Coeliac disease
- Coexisting severe mental illness and substance misuse: assessment and management in healthcare settings
- Coexisting severe mental illness and substance misuse: community health and social care services
- Cold homes, reducing preventable excess winter deaths (see excess winter deaths and illnesses associated with cold homes)
- Colonoscopic surveillance
- Colorectal cancer
- Colorectal cancer prevention (see colonoscopic surveillance)
- Common mental health disorders in primary care
- Community engagement
- Community pharmacies: promoting health and wellbeing
- Community-acquired pneumonia (see pneumonia)
- Complex fractures (see trauma)
- Complex psychosis, rehabilitation for adults (see rehabilitation for adults with complex psychosis)
- Complex social factors and pregnancy: service provision
- Concussion and coma (see head injury)
- Conduct disorders and antisocial behaviour in children and young people
- Constipation
- Contraception
- Contraceptive services for under 25s
- Controlled drugs: safe use and management
- Cough (see self-limiting respiratory tract and ear infections – antibiotic prescribing)
- Criminal justice system, health of people in
- Critical illness rehabilitation
- Crohn’s disease
- Cycling and walking
- Cystic fibrosis
- Cystitis (see urinary tract infections)
- Deafness (see hearing loss)
- Decision-making and mental capacity
- Deep vein thrombosis (see venous thromboembolism)
- Delirium
- Dementia
- Dementia, disability and frailty in later life: mid-life approaches to delay or prevent onset
- Dental and oral health
- Dental perioperative care (see perioperative care)
- Dental services, local authority improvement approaches (see oral health improvement for local authorities and their partners)
- Depression
- Depression in children and young people
- Developmental follow-up of children and young people born preterm
- Diabetes
- Diabetes (type 2) prevention
- Diabetes in children and young people
- Diabetes in pregnancy
- Diabetic foot care
- Diarrhoea and vomiting in children
- Diet
- Diverticular disease
- Diverticulitis (see diverticular disease)
- Diverticulosis (see diverticular disease)
- Domestic violence and abuse
- Domiciliary care for older people
- Donor breast milk banks
- Drug allergy
- Drug misuse management in over 16s
- Drug misuse prevention
- Dual diagnosis (see coexisting severe mental illness and substance misuse: assessment and management in healthcare settings)
- Dual diagnosis (see coexisting severe mental illness and substance misuse: community health and social care services)
- Dyspepsia and gastro-oesophageal reflux disease
- Ear, nose and throat conditions
- Early and locally advanced breast cancer
- Early-onset neonatal infection
- Earwax removal (see hearing loss)
- Eating disorders
- Ectopic pregnancy and miscarriage
- Eczema
- Emergency and acute medical care in over 16s: service delivery and organisation
- End of life care for infants, children and young people (see end of life care for people with life-limiting conditions)
- End of life care for people with life-limiting conditions
- Endocarditis prophylaxis (see prophylaxis against infective endocarditis)
- Endocrine cancers
- Endocrine, nutritional and metabolic conditions
- Endometriosis
- Enteral nutrition (see nutrition support in adults)
- Epilepsy
- Excess winter deaths and illnesses associated with cold homes
- Exercise (see physical activity)
- Eye conditions
- Faecal incontinence
- Falls in older people (see preventing falls in older people)
- Faltering growth
- Familial breast cancer
- Familial hypercholesterolaemia
- Fatty liver disease, non-alcoholic
- Fertility
- Fertility, pregnancy and childbirth
- Fever in under 5s
- Feverish illness in children
- Fibroids, uterine (see heavy menstrual bleeding)
- Flu vaccination (see influenza)
- Food allergy in under 19s
- Foot care for people with diabetes
- Fractured neck of femur (see hip fracture)
- Fractures (see trauma)
- Fragility fractures (see osteoporosis)
- Gallstone disease
- Gastric cancer (see oesophageal and gastric cancer)
- Gastroenteritis in children (see diarrhoea and vomiting in children)
- Gastrointestinal bleeding, acute upper
- Gastrointestinal cancers
- Gastrointestinal conditions
- Gastro-oesophageal reflux disease and dyspepsia
- Generalised anxiety disorder
- Genomic biomarker-based treatment for solid tumours
- Gestational diabetes
- Glaucoma
- Glue ear (see surgical management of otitis media with effusion in children)
- Goitre (see thyroid disease)
- Graves' disease (see thyroid disease)
- Growth, faltering
- Gynaecological conditions (see urogenital conditions)
- Haematemesis (see acute upper gastrointestinal bleeding)
- Haematological cancers (see blood and bone marrow cancers)
- Harmful sexual behaviour among children and young people
- Head injury
- Headaches
- Health of people in the criminal justice system
- Health services, adult user experience
- Healthcare-associated infections, prevention and control
- Hearing loss
- Heart defects, structural
- Heart failure, acute
- Heart failure, chronic
- Heart rhythm conditions
- Heartburn (see dyspepsia and gastro-oesophageal reflux disease)
- Heavy menstrual bleeding
- Hepatitis B (chronic)
- Hepatitis B and C testing
- High blood pressure (see hypertension)
- Hip fracture
- Hip replacement (see joint replacement)
- Histology-independent treatment for solid tumours
- HIV testing and prevention
- Home care for older people
- Hospital-acquired pneumonia (see pneumonia)
- Human and animal bites
- Hypercholesterolaemia, familial (see familial hypercholesterolaemia)
- Hypercholesterolaemia, non-familial (see cardiovascular disease prevention)
- Hyperkinetic disorder (see attention deficit hyperactivity disorder)
- Hyperparathyroidism (primary)
- Hyperphosphataemia in chronic kidney disease
- Hypertension
- Hypertension in pregnancy
- Hyperthyroidism (see thyroid disease)
- Hypothyroidism (see thyroid disease)
- Idiopathic pulmonary fibrosis
- Immune system and blood conditions
- Immunisations for under 19s
- Impetigo
- Inadvertent perioperative hypothermia
- Incontinence, faecal
- Incontinence, urinary
- Incontinence, urinary in neurological disease
- Independence and mental wellbeing in older people
- Indoor air quality at home (see air pollution)
- Induction of labour
- Infant feeding (see maternal and child nutrition)
- Infant growth, faltering
- Infections, antimicrobials for common
- Infective endocarditis, prophylaxis
- Inflammatory bowel disease (see Crohn's disease)
- Inflammatory bowel disease (see ulcerative colitis)
- Influenza
- Injuries, multiple serious (see trauma)
- Insect bites and stings
- Intermediate care including reablement
- Interstitial lung disease (see idiopathic pulmonary fibrosis)
- Intraoperative care (see perioperative care)
- Intrapartum care
- Intrapartum care for women with existing medical conditions
- Intrapartum care for women with obstetric complications
- Intravenous fluid therapy in hospital
- Irritable bowel syndrome in adults
- Jaundice, neonatal
- Joint replacement
- Kidney cancer (see renal cancer)
- Kidney conditions
- Kidney disease, chronic
- Kidney injury, acute
- Kidney stones
- Knee replacement (see joint replacement)
- Labour (see intrapartum care)
- Labour, care for women with existing medical conditions (see intrapartum care for women with existing medical conditions)
- Labour, care for women with obstetric complications (see intrapartum care for women with obstetric complications)
- Labour, induced
- Larynx, mouth and throat cancer (see upper aerodigestive tract cancer)
- Learning disabilities and behaviour that challenges
- Learning disabilities, mental health problems
- Learning disabilities, older people
- Leg ulcers
- Leukaemia (see blood and bone marrow cancers)
- Life-limiting conditions, end of life care (see end of life care for people with life-limiting conditions)
- Lifestyle weight management services for overweight or obese adults
- Lifestyle weight management services for overweight or obese children and young people
- Lipid modification (see cardiovascular disease prevention)
- Liver cancers
- Liver conditions
- Liver disease, non-alcoholic fatty
- Local formulary development
- Long-term sickness absence and capability to work
- Looked-after babies, children and young people
- Low back pain and sciatica
- Lower limb peripheral arterial disease
- Lower urinary tract symptoms in men
- Lung cancer
- Lyme disease
- Lymphoma (see blood and bone marrow cancers)
- Lymphoma, non-Hodgkin's
- Macular degeneration, age-related
- Managing long-term sickness absence and capability to work
- Managing medicines for people receiving social care in the community
- Managing medicines in care homes
- Manic depression (see bipolar disorder)
- Maternal and child nutrition
- Maternity settings, safe midwifery staffing
- Medicines adherence (see medicines optimisation)
- Medicines optimisation
- Melanoma
- Meningitis, bacterial and meningococcal septicaemia
- Menopause
- Menorrhagia (see heavy menstrual bleeding)
- Mental capacity and decision-making
- Mental health disorders (common) in primary care
- Mental health problems in people with learning disabilities
- Mental health services, adult service user experience
- Mental health, antenatal and postnatal
- Mental illness (severe) and substance misuse, coexisting (see coexisting severe mental illness and substance misuse: community health and social care services)
- Mental wellbeing and independence in older people
- Mental wellbeing at work
- Metabolic conditions (see endocrine, nutritional and metabolic conditions)
- Metastatic malignant disease of unknown primary origin
- Metastatic spinal cord compression
- Migraine (see headaches)
- Miscarriage and ectopic pregnancy
- Monitoring ill patients (see acutely ill patients in hospital)
- Motor neurone disease
- Mouth, larynx and throat cancer (see upper aerodigestive tract cancer)
- Multimorbidity
- Multiple long-term conditions (see multimorbidity)
- Multiple pregnancy (see twin and triplet pregnancy)
- Multiple sclerosis
- Multiple serious injuries (see trauma)
- Musculoskeletal conditions
- Myalgic encephalomyelitis, chronic fatigue syndrome
- Myeloma
- Myocardial infarction, secondary prevention and rehabilitation (see acute coronary syndromes: secondary prevention and rehabilitation)
- Needle and syringe programmes
- Neonatal infection (see early-onset neonatal infection)
- Neonatal jaundice
- Neonatal parenteral nutrition
- Neurological conditions
- Neurological disease, urinary incontinence
- Neuropathic pain
- Neutropenic sepsis
- Nocturnal enuresis (see bedwetting in children and young people)
- Non-alcoholic fatty liver disease
- Non-Hodgkin’s lymphoma
- Non-STEMI (see acute coronary syndromes: early management)
- Nose conditions (see ear, nose and throat conditions)
- NTRK fusion-positive solid tumours
- Nutrition support in adults
- Nutritional conditions (see endocrine, nutritional and metabolic conditions)
- Obesity
- Obesity: working with local communities
- Obsessive-compulsive disorder and body dysmorphic disorder
- Oesophageal and gastric cancer
- Older people with social care needs and multiple long-term conditions (see social care for older people with multiple long-term conditions)
- Older people, learning disabilities
- Older people: independence and mental wellbeing
- Opioids for pain relief in palliative care
- Oral and dental health
- Oral health for adults in care homes
- Oral health improvement for local authorities and their partners
- Organ donation for transplantation
- Osteoarthritis
- Osteoporosis
- Otitis media (acute) (see self-limiting respiratory tract and ear infections – antibiotic prescribing)
- Otitis media with effusion, surgical management in children
- Outdoor air quality and health (see air pollution)
- Ovarian cancer
- Overactive bladder (see urinary incontinence)
- Overweight or obese adults, lifestyle weight management services
- Overweight or obese children and young people, lifestyle weight management services
- Pain, neuropathic
- Palliative care, for people with life-limiting conditions (see end of life care for people with life-limiting conditions)
- Palliative care, opioids
- Pancreatic cancer
- Pancreatitis
- Panic disorder
- Parenteral nutrition (see nutrition support in adults)
- Parkinson’s disease
- Patient experience in adult NHS services
- Patient group directions
- Pelvic organ prolapse
- People with learning disabilities, mental health problems
- People’s experience in adult social care services
- Perioperative care
- Perioperative hypothermia, inadvertent
- Peripheral arterial disease, lower limb
- Personality disorders
- Physical activity
- Pneumonia
- Postnatal and antenatal mental health
- Postnatal care
- Postoperative care (see perioperative care)
- Post-traumatic stress disorder
- Pre-eclampsia (see hypertension in pregnancy)
- Pregnancy (see fertility, pregnancy and childbirth)
- Pregnancy and complex social factors: service provision
- Pregnancy, diabetes
- Pregnancy, hypertension
- Pregnancy, preventing teenage (see preventing sexually transmitted infections and under-18 conceptions)
- Pregnancy, twins and triplets (see twin and triplet pregnancy)
- Premature labour and birth (see preterm labour and birth)
- Premature ovarian insufficiency (see menopause)
- Preoperative care (see perioperative care)
- Preoperative tests
- Pressure ulcers
- Preterm labour and birth
- Preventing falls in older people
- Preventing sexually transmitted infections and under-18 conceptions
- Preventing suicide
- Preventing type 2 diabetes
- Prevention and control of healthcare-associated infections
- Primary hyperparathyroidism
- Prison, health of people in
- Promoting mental wellbeing at work
- Prophylaxis against infective endocarditis
- Prostate cancer
- Prostatitis – antimicrobial prescribing
- Psoriasis
- Psoriatic arthritis (see spondyloarthritis)
- Psychosis and schizophrenia
- Psychosis with coexisting substance misuse (see coexisting severe mental illness and substance misuse: assessment and management in healthcare settings)
- Psychosis, complex, rehabilitation for adults (see rehabilitation for adults with complex psychosis)
- Pulmonary embolism (see venous thromboembolism)
- Pyelonephritis (see urinary tract infections)
- Reablement (see intermediate care)
- Reactive arthritis (see spondyloarthritis)
- Rehabilitation after critical illness
- Rehabilitation for adults with complex psychosis
- Renal and ureteric stones
- Renal cancer
- Renal conditions
- Renal failure, acute (see acute kidney injury)
- Renal failure, established (see chronic kidney disease)
- Renal replacement therapy (see chronic kidney disease)
- Respiratory conditions
- Respiratory syncytial virus infection (see bronchiolitis in children)
- Respiratory tract and ear infections (self-limiting), antibiotic prescribing
- Rheumatoid arthritis
- Safe midwifery staffing for maternity settings
- Safe staffing for nursing in adult inpatient wards in acute hospitals
- Sarcoma
- Schizophrenia and psychosis
- Sciatica and low back pain
- Sedation in children and young people
- Seizures (see epilepsy)
- Self-harm
- Self-limiting respiratory tract and ear infections – antibiotic prescribing
- Sepsis
- Septicaemia, meningococcal and bacterial meningitis (see bacterial meningitis and meningococcal septicaemia)
- Service user experience in adult mental health services
- Severe mental illness and substance misuse, coexisting (see coexisting severe mental illness and substance misuse: community health and social care services)
- Sexual behaviour, harmful
- Sexually transmitted infections, prevention
- Shoulder replacement (see joint replacement)
- Sickle cell disease: acute painful episode
- Sinusitis (see self-limiting respiratory tract and ear infections – antibiotic prescribing)
- Skin cancer
- Skin cancer prevention (see sunlight exposure: risks and benefits)
- Skin conditions
- Skin damage (see skin conditions)
- Smokeless tobacco cessation: South Asian communities
- Smoking
- Smoking cessation in secondary care
- Smoking: tobacco harm-reduction approaches
- Social and emotional wellbeing for children and young people
- Social anxiety disorder
- Social care for older people with multiple long-term conditions
- Social care services, people's experience
- Social factors (complex) in pregnancy: service provision
- Sore throat (see self-limiting respiratory tract and ear infections – antibiotic prescribing)
- Spasticity in children and young people
- Specialist neonatal respiratory care in preterm babies
- Spinal cord compression, metastatic (see metastatic spinal cord compression)
- Spinal injury (see trauma)
- Spondyloarthritis
- STEMI (see acute coronary syndromes: early management)
- Stomach cancer (see oesophageal and gastric cancer)
- Stroke
- Structural heart defects
- Substance misuse and severe mental illness, coexisting (see coexisting severe mental illness and substance misuse: community health and social care services)
- Suicide prevention
- Sunlight exposure: risks and benefits
- Supporting adult carers
- Surgical care (see perioperative care)
- Surgical management of otitis media with effusion in children
- Surgical site infection (see prevention and control of healthcare-associated infections)
- Suspected cancer recognition and referral
- Suspected neurological conditions recognition and referral (see neurological conditions)
- Teenage pregnancy prevention (see preventing sexually transmitted infections and under-18 conceptions)
- Termination of pregnancy (see abortion care)
- Throat conditions (see ear, nose and throat conditions)
- Throat, larynx and mouth cancer (see upper aerodigestive tract cancer)
- Thyroid disease
- Thyrotoxicosis (see thyroid disease)
- Tinnitus
- Tissue viability (see pressure ulcers)
- Tobacco (see smoking)
- Tobacco cessation (smokeless): South Asian communities
- Tobacco harm reduction approaches
- Transfusion (see blood transfusion)
- Transient ischaemic attack (see stroke)
- Transient loss of consciousness
- Transition between community or care home and inpatient mental health settings
- Transition between inpatient hospital settings and community or care home settings for adults with social care needs
- Transition from children's to adults' services
- Trauma
- Triplet and twin pregnancy
- Tuberculosis
- Twin and triplet pregnancy
- Type 1 and type 2 diabetes in children and young people
- Type 1 diabetes in adults
- Type 2 diabetes in adults
- Type 2 diabetes prevention
- Ulcerative colitis
- Unintentional injuries among under-15s
- Unstable angina (see acute coronary syndromes: early management)
- Upper aerodigestive tract cancer
- Upper gastrointestinal bleeding, acute
- Ureteric stones
- Urinary incontinence and pelvic organ prolapse in women
- Urinary incontinence in neurological disease
- Urinary tract infections
- Urinary tract symptoms in men, lower
- Urogenital conditions
- Urological conditions (see urogenital conditions)
- Vaccinations (see immunisation for children and young people)
- Varicose veins in the legs
- Venous thromboembolism
- Violence and aggression
- Vitamin D: supplement use in specific population groups
- Vomiting and diarrhoea in children
- Walking and cycling
- Weight management services (lifestyle) for overweight or obese adults
- Weight management services (lifestyle) for overweight or obese children and young people
- Winter deaths and illnesses associated with cold homes (see excess winter deaths and illnesses associated with cold homes)
- Workplace health: policy and management practices
- Young offender institutions, health of people in
-
Conditions and diseases
-
Blood and immune system conditions
- Allergies
- Anaphylaxis: assessment and referral after emergency treatment
- Blood and bone marrow cancers
- Blood conditions
- Coeliac disease
- Breast conditions
-
Cancer
- Bladder cancer
- Blood and bone marrow cancers
- Brain tumours and metastases
- Breast cancer
- Cervical cancer
- Complications of cancer
- Endocrine cancers
- Gastrointestinal cancers
- Genomic biomarker-based treatment for solid tumours
- Liver cancers
- Lung cancer
- Metastatic malignant disease of unknown primary origin
- Ovarian cancer
- Pancreatic cancer
- Prostate cancer
- Renal cancer
- Sarcoma
- Skin cancer
- Suspected cancer recognition and referral
- Upper aerodigestive tract cancer
-
Cardiovascular conditions
- Acute coronary syndromes
- Aortic aneurysms
- Cardiovascular disease: identifying and supporting people most at risk of dying early
- Chest pain
- Heart failure
- Heart rhythm conditions
- Hypertension
- Lipid disorders
- Lower limb peripheral arterial disease
- Prophylaxis against infective endocarditis
- Stable angina
- Stroke
- Structural heart defects
- Varicose veins in the legs
- Venous thromboembolism
- Chronic fatigue syndrome myalgic encephalomyelitis
- Diabetes and other endocrine, nutritional and metabolic conditions
-
Digestive tract conditions
- Acute upper gastrointestinal bleeding
- Barrett’s oesophagus
- Coeliac disease
- Constipation
- Cystic fibrosis
- Diarrhoea and vomiting in children
- Diverticular disease
- Dyspepsia and gastro-oesophageal reflux disease
- Faecal incontinence
- Gallstone disease
- Gastrointestinal cancers
- Gastrointestinal conditions
- Inflammatory bowel disease
- Irritable bowel syndrome in adults
- Pancreatitis
- Upper aerodigestive tract cancer
- Ear, nose and throat conditions
- Eye conditions
-
Fertility, pregnancy and childbirth
- Contraception
- Fertility
- Intrapartum care
-
Postnatal care
- Antenatal and postnatal mental health
- Developmental follow-up of children and young people born preterm
- Donor breast milk banks
- Early-onset neonatal infection
- Faltering growth
- Maternal and child nutrition
- Neonatal jaundice
- Neonatal parenteral nutrition
- Specialist neonatal respiratory care in preterm babies
- Pregnancy
- Genetic conditions
- Gynaecological conditions
-
Infections
-
Antibiotic use
- Antimicrobial prescribing for common infections
- Antimicrobial stewardship
- Bites and stings – antimicrobial prescribing
- Bronchiectasis (non-cystic fibrosis) – antimicrobial prescribing
- Cellulitis and erysipelas – antimicrobial prescribing
- Early-onset neonatal infection
- Foot care for people with diabetes
- Impetigo
- Leg ulcers
- Pneumonia
- Prophylaxis against infective endocarditis
- Prostatitis – antimicrobial prescribing
- Self-limiting respiratory tract and ear infections – antibiotic prescribing
- Urinary tract infections
- Bacterial meningitis and meningococcal septicaemia in under 16s
- Fever in under 5s
- Hepatitis
- HIV testing and prevention
- Influenza
- Lyme disease
- Preventing sexually transmitted infections and under-18 conceptions
- Prevention and control of healthcare-associated infections
- Sepsis
- Tuberculosis
-
Antibiotic use
- Injuries, accidents and wounds
- Kidney conditions
-
Liver conditions
- Alcohol-use disorders
- Chronic liver disease
- Hepatitis
- Liver cancers
-
Mental health and behavioural conditions
- Alcohol-use disorders
- Antenatal and postnatal mental health
- Antisocial behaviour and conduct disorders in children and young people
- Anxiety
- Attachment difficulties in children and young people
- Attention deficit hyperactivity disorder
- Autism spectrum disorder
- Bipolar disorder
- Common mental health disorders in primary care
- Decision-making and mental capacity
- Delirium
- Dementia
- Depression
- Depression in children and young people
- Eating disorders
- Harmful sexual behaviour among children and young people
- Health of people in the criminal justice system
- Learning disabilities and behaviour that challenges
- Mental health problems in people with learning disabilities
- Personality disorders
- Post-traumatic stress disorder
- Psychosis and schizophrenia
- Rehabilitation for adults with complex psychosis
- Self-harm
- Service user experience in adult mental health services
- Transition between community or care home and inpatient mental health settings
- Violence and aggression
- Multiple long-term conditions
- Musculoskeletal conditions
- Neonatal parenteral nutrition
-
Neurological conditions
- Brain tumours and metastases
- Cerebral palsy
- Delirium
- Dementia
- Epilepsy
- Faecal incontinence
- Headaches
- Metastatic spinal cord compression
- Motor neurone disease
- Multiple sclerosis
- Neuropathic pain
- Parkinson’s disease
- Spasticity in children and young people
- Transient loss of consciousness
- Trauma
- Urinary incontinence
- Oral and dental health
- Respiratory conditions
- Skin conditions
- Urogenital conditions
- Urological conditions
-
Blood and immune system conditions
-
Health protection
- Communicable diseases
- Drug misuse
- Environment
-
Lifestyle and wellbeing
- Air pollution
- Alcohol
- Behaviour change
- Cardiovascular disease: identifying and supporting people most at risk of dying early
- Community pharmacies: promoting health and wellbeing
- Diet, nutrition and obesity
- Drug misuse
-
Mental health and wellbeing
- Antenatal and postnatal mental health
- Cardiovascular disease: identifying and supporting people most at risk of dying early
- Decision-making and mental capacity
- Health of people in the criminal justice system
- Mental wellbeing and independence in older people
- Promoting mental wellbeing at work
- Social and emotional wellbeing for children and young people
- Oral and dental health
- Physical activity
- Sexual health
- Smoking and tobacco
- Suicide prevention
- Sunlight exposure
-
Population groups
- Adult carers
- Behaviour change
- Black and minority ethnic groups
-
Children and young people
- Alcohol-use disorders
- Antisocial behaviour and conduct disorders in children and young people
- Asthma
- Attachment difficulties in children and young people
- Attention deficit hyperactivity disorder
- Autism spectrum disorder
- Bedwetting in children and young people
- Bronchiolitis in children
- Cerebral palsy
- Child abuse and neglect
- Constipation
- Depression in children and young people
- Diabetes in children and young people
- Diarrhoea and vomiting in children
- Dyspepsia and gastro-oesophageal reflux disease
- Eczema
- End of life care for people with life-limiting conditions
- Faltering growth
- Fever in under 5s
- Food allergy in under 19s
- Harmful sexual behaviour among children and young people
- Immunisations for under 19s
- Intravenous fluid therapy in hospital
- Lifestyle weight management services for overweight or obese children and young people
- Looked-after babies, children and young people
- Pneumonia
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Neonatal jaundice
About
What is covered
This NICE Pathway covers the care of newborn babies (from birth to 28 days) with jaundice.
Updates
Updates to this NICE Pathway
26 October 2016 A recommendation was amended to clarify when intensified phototherapy should be used in relation to time since birth at treatment levels.
10 May 2016 Pathway updated and restructured in line with the partial update to NICE's guideline on jaundice in newborn babies under 28 days. Summarised recommendations replaced with full recommendations.
6 March 2014 Neonatal jaundice (NICE quality standard 57) added.
Person-centred care
People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.
Your responsibility
Guidelines
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Technology appraisals
The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Medical technologies guidance, diagnostics guidance and interventional procedures guidance
The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Short Text
What is covered
This NICE Pathway covers the care of newborn babies (from birth to 28 days) with jaundice.
Updates
Updates to this NICE Pathway
26 October 2016 A recommendation was amended to clarify when intensified phototherapy should be used in relation to time since birth at treatment levels.
10 May 2016 Pathway updated and restructured in line with the partial update to NICE's guideline on jaundice in newborn babies under 28 days. Summarised recommendations replaced with full recommendations.
6 March 2014 Neonatal jaundice (NICE quality standard 57) added.
Sources
NICE guidance and other sources used to create this interactive flowchart.
Jaundice in newborn babies under 28 days (2010 updated 2016) NICE guideline CG98
Jaundice in newborn babies under 28 days (2014) NICE quality standard 57
Related
Quality standards
Jaundice in newborn babies under 28 days
These quality statements are taken from the jaundice in newborn babies under 28 days quality standard. The quality standard defines clinical best practice for jaundice in newborn babies under 28 days and should be read in full.
Quality statements
Information for parents or carers
This quality statement is taken from the neonatal jaundice quality standard. The quality standard defines clinical best practice in neonatal jaundice care and should be read in full.
Quality statement
Parents or carers of newborn babies have a discussion with healthcare professionals and are given written information about neonatal jaundice within 24 hours of the birth, including what to look for and who to contact if they are concerned.
Rationale
Early identification of neonatal jaundice is essential to ensure that babies receive appropriate treatment for either underlying disease or for hyperbilirubinaemia caused by physiological jaundice in order to prevent complications and achieve the best clinical outcomes. Advising parents or carers about what to look for and when to contact a healthcare professional will help to ensure rapid access to treatment if needed. This is particularly important in the context of early discharge from maternity units. Giving parents or carers information about neonatal jaundice will also reassure them that it is common, usually transient and harmless, and that normal feeding and normal care of the baby can usually continue (including extra support with breastfeeding). This will reduce their anxiety if their baby does develop jaundice and needs investigations or treatment. Parents or carers of newborn babies receive a large amount of information, which is why a discussion, in addition to written information, is important.
Quality measures
Structure
a) Evidence of local availability of written information about neonatal jaundice for parents or carers of newborn babies.
Data source: Local data collection.
b) Evidence of local arrangements to ensure telephone access to a relevant healthcare professional for parents or carers who are concerned about neonatal jaundice.
Data source: Local data collection.
Process
Proportion of newborn babies whose parents or carers have a discussion with healthcare professionals and receive written information about neonatal jaundice within 24 hours of the birth, including what to look for and who to contact if they are concerned.
Numerator – the number of babies in the denominator whose parents or carers have a discussion with healthcare professionals and receive written information about neonatal jaundice within 24 hours of the birth, including what to look for and who to contact if they are concerned.
Denominator – the number of newborn babies.
Data source: Local data collection.
What the quality statement means for service providers, healthcare professionals and commissioners
Service providers ensure the availability of written information about neonatal jaundice (including what to look for and who parents or carers can contact if they are concerned) and that healthcare professionals understand and act on the need to discuss this with parents or carers of newborn babies.
Healthcare professionals ensure that they discuss neonatal jaundice with parents or carers of newborn babies and give them written information within 24 hours of the birth, including what to look for and who to contact if they are concerned.
Commissioners ensure that they commission services in which written information on neonatal jaundice is available and there is telephone access to relevant healthcare professionals for parents or carers who are concerned about jaundice.
What the quality statement means for patients and carers
Parents or carers of newborn babies have a discussion with healthcare professionals and are given written information about jaundice within 24 hours of the baby being born. This includes information about how to check whether the baby might have jaundice, as well as who to contact if they are concerned.
Source guidance
- Neonatal jaundice (NICE clinical guideline 98), recommendation 1.1.1 (key priority for implementation)
- Postnatal care (NICE clinical guideline 37), recommendation 1.4.16
Definitions of terms used in this quality statement
Information about neonatal jaundice
Information about neonatal jaundice should be tailored to the needs and expressed concerns of parents or carers of newborn babies. The information should be provided through discussion backed up by written information. Care should be taken to avoid causing unnecessary anxiety to parents or carers. The combination of discussion and written information should cover:
- factors that influence the development of significant hyperbilirubinaemia
- how to check the baby for jaundice (signs and symptoms to look for):
- the naked baby in bright and preferably natural light
- note that examination of the sclerae, gums and blanched skin is useful across all skin tones
- who to contact if they suspect jaundice, jaundice is getting worse, or their baby is passing pale chalky stools or dark urine
- the importance of recognising jaundice in the first 24 hours and of seeking urgent medical advice
- the fact that neonatal jaundice is common, and reassurance that it is usually transient and harmless
- reassurance that support will be provided to continue with normal feeding (including extra advice and support with breastfeeding) and normal care of the baby.
[Adapted from Postnatal care (NICE clinical guideline 37) recommendation 1.4.16, Neonatal jaundice (NICE clinical guideline 98) recommendations 1.1.1 (key priority for implementation) and 1.2.5, and Postnatal care (NICE quality standard 37) statement 3]
A neonatal jaundice parent information factsheet and information for the public about neonatal jaundice are available from NICE.
Equality and diversity considerations
Information about neonatal jaundice should be accessible to parents or carers with additional needs such as physical, sensory or learning disabilities, and to parents or carers who do not speak or read English. Parents or carers of babies with neonatal jaundice in any setting should have access to an interpreter or advocate if needed.
Extra support with visual checks for jaundice in babies and checking nappies for pale stools or dark urine should be provided to parents or carers with sight impairments.
It may be difficult to recognise jaundice in some babies with dark skin tones. The instructions about how to check the baby for jaundice are written to be useful across all skin tones: examination of the sclerae, gums and blanched skin in bright (preferably natural) light.
Measurement of bilirubin level in babies more than 24 hours old
This quality statement is taken from the neonatal jaundice quality standard. The quality standard defines clinical best practice in neonatal jaundice care and should be read in full.
Quality statement
Babies with suspected jaundice who are more than 24 hours old have their bilirubin level measured within 6 hours of a healthcare professional suspecting jaundice or a parent or carer reporting possible jaundice.
Rationale
Visual inspection is used to recognise jaundice but is not very good for assessing the clinical severity of the jaundice. Although bilirubin should not be measured routinely in babies who are not visibly jaundiced, measuring bilirubin levels in babies with suspected or obvious visible jaundice assesses the degree of jaundice and determines whether the baby needs further investigations or treatment. Measuring the bilirubin level as soon as possible (within 6 hours) in babies with suspected jaundice will ensure that those with rapidly rising bilirubin levels are identified promptly for treatment. Bilirubin can be measured by taking a blood sample (serum bilirubin) or, within defined circumstances (see Definitions below), using a transcutaneous bilirubinometer (followed by a blood test if needed). Transcutaneous bilirubinometers, although not as accurate as measuring serum bilirubin, are more accurate than visual inspection alone, are non-invasive, can be used in the community and provide instant results.
Quality measures
Structure
Evidence of local protocols and adequate access to bilirubin measurement, to ensure that babies with suspected jaundice who are more than 24 hours old have their bilirubin level measured within 6 hours of a healthcare professional suspecting jaundice or a parent or carer reporting possible jaundice.
Data source: Local data collection.
Process
a) Proportion of babies with suspected jaundice who are more than 24 hours old who have their bilirubin level measured.
Numerator – the number of babies in the denominator having their bilirubin level measured.
Denominator – the number of babies with suspected jaundice who are more than 24 hours old.
Data source: Local data collection.
b) Proportion of babies with suspected jaundice who are more than 24 hours old who have their bilirubin level measured within 6 hours of a healthcare professional suspecting jaundice or a parent or carer reporting possible jaundice.
Numerator – the number of babies in the denominator having their bilirubin level measured within 6 hours of a healthcare professional suspecting jaundice or a parent or carer reporting possible jaundice.
Denominator – the number of babies with suspected jaundice who are more than 24 hours old who have had their bilirubin measured.
Data source: Local data collection.
What the quality statement means for service providers, healthcare professionals and commissioners
Service providers ensure adequate access to bilirubin measurement and have local education and protocols in place that enable healthcare professionals to measure, within 6 hours, bilirubin levels in babies with suspected jaundice who are more than 24 hours old.
Healthcare professionals ensure that they measure, within 6 hours, bilirubin levels in babies with suspected jaundice who are more than 24 hours old.
Commissioners ensure that they commission services with adequate access to bilirubin measurement that enable healthcare professionals to measure, within 6 hours, bilirubin levels in babies with suspected jaundice who are more than 24 hours old.
What the quality statement means for patients and carers
Babies with suspected jaundice who are more than 24 hours old have their bilirubin level measured within 6 hours of the possible jaundice being noted (bilirubin is the substance that causes the yellow colour seen in jaundice). This may be done by a healthcare professional at the baby’s home, but it may need to be done at a hospital.
Source guidance
- Neonatal jaundice (NICE clinical guideline 98), recommendations 1.2.14 and 1.2.15 (key priority for implementation).
Definitions of terms used in this quality statement
Measurement of bilirubin level
When measuring the bilirubin level in babies more than 24 hours old:
- use a transcutaneous bilirubinometer in babies with a gestational age of 35 weeks or more (always use serum bilirubin measurement to determine the bilirubin level in babies less than 35 weeks’ gestational age)
- if a transcutaneous bilirubinometer is not available, measure the serum bilirubin
- if a transcutaneous bilirubinometer measurement indicates a bilirubin level greater than 250 micromol/litre check the result by measuring the serum bilirubin
- always use serum bilirubin measurement for babies at or above the relevant treatment thresholds for their postnatal age, and for all subsequent measurements
- do not use an icterometer.
[Adapted from Neonatal jaundice (NICE clinical guideline 98) recommendation 1.2.15]
Within 6 hours
The 6-hour timeframe begins when a healthcare professional suspects jaundice or when a parent or carer reports possible jaundice.
[Expert opinion]
Transcutaneous bilirubinometer
A device that uses reflected light to measure the yellow colour (bilirubin level) in the skin.
Equality and diversity considerations
Some parents or carers may find it difficult to access postnatal care for their baby after discharge from hospital; for example, they may be unable to afford to travel to their local clinic or hospital. This quality statement focuses on the period after the initial 24 hours after birth (and so in many cases after discharge from hospital). It promotes equitable access to postnatal care by making reference to the use (where clinically indicated) of transcutaneous bilirubinometers, which can be used in the community.
Management of hyperbilirubinaemia: treatment thresholds
This quality statement is taken from the neonatal jaundice quality standard. The quality standard defines clinical best practice in neonatal jaundice care and should be read in full.
Quality statement
Babies with hyperbilirubinaemia are started on treatment in accordance with standardised threshold tables or charts.
Rationale
Once jaundice in babies is recognised, it is important to know when and how to treat it. Phototherapy is an effective treatment for significant hyperbilirubinaemia and can reduce the need for exchange transfusion (a procedure involving a complete changeover of blood), which is necessary only in the most severe cases. The consistent use of treatment thresholds, alongside NICE guidance, will help to ensure a balance between the thresholds being low enough to prevent complications (such as kernicterus) but not so low that phototherapy is used unnecessarily.
Quality measures
Structure
Evidence of local arrangements to ensure the use of standardised treatment threshold tables or charts when starting treatment for babies with hyperbilirubinaemia.
Data source: Local data collection.
Process
Proportion of babies identified with hyperbilirubinaemia who are started on treatment in accordance with standardised threshold tables or charts.
Numerator – the number of babies in the denominator who are started on treatment in accordance with standardised threshold tables or charts.
Denominator – the number of babies identified with hyperbilirubinaemia.
Data source: Local data collection.
Outcome
Incidence of kernicterus.
Data source: Local data collection. The ICD-10 code for Kernicterus is P57. Data available via Hospital episode statistics (HES) online or the Neonatal Critical Care Minimum Data Set.
What the quality statement means for service providers, healthcare professionals and commissioners
Service providers ensure that healthcare professionals have access to, and are competent to use, standardised threshold tables or charts when deciding whether to start (or not start) treatment for babies with hyperbilirubinaemia.
Healthcare professionals ensure that they use standardised threshold tables or charts when deciding whether to start (or not start) treatment for babies with hyperbilirubinaemia.
Commissioners ensure that they commission services in which healthcare professionals have access to, and are competent to use, standardised threshold tables or charts when deciding whether to start (or not start) treatment for babies with hyperbilirubinaemia.
What the quality statement means for patients and carers
Babies with high levels of bilirubin receive treatment according to tables or charts that tell the healthcare team whether to start (or not start) treatment. The information used when making decisions about when to start treatment includes how high the baby’s bilirubin level is, the age of the baby when the bilirubin was measured, and the baby’s maturity at the time of birth (that is, how many weeks of pregnancy they were born after).
Source guidance
- Neonatal jaundice (NICE clinical guideline 98), recommendations 1.3.4 (key priority for implementation) and 1.2.13.
Definitions of terms used in this quality statement
Standardised threshold tables or charts
These are tables or charts that help healthcare professionals to implement treatment thresholds for phototherapy and exchange transfusion in accordance with NICE clinical guideline 98. These include treatment threshold graphs published on the NICE website. All tables or charts should take into account serum bilirubin level, gestational age and postnatal age.
Effective interventions library
Effective interventions library
Successful effective interventions library details
Implementation
NICE has produced resources to help implement its guidance on:
Information for the public
NICE has written information for the public on each of the following topics.
Pathway information
Person-centred care
People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.
Your responsibility
Guidelines
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Technology appraisals
The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Medical technologies guidance, diagnostics guidance and interventional procedures guidance
The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Supporting information
Consensus-based bilirubin thresholds for management of babies 38 weeks or more gestational age with hyperbilirubinaemia
Age (hours) | Bilirubin measurement (micromol/litre) | |||
---|---|---|---|---|
0 | >100 | >100 | ||
6 | > 125 | > 150 | ||
12 | > 150 | > 200 | ||
18 | > 175 | > 250 | ||
24 | > 200 | > 300 | ||
30 | > 212 | > 350 | ||
36 | > 225 | > 400 | ||
42 | > 237 | > 450 | ||
48 | > 250 | > 450 | ||
54 | > 262 | > 450 | ||
60 | > 275 | > 450 | ||
66 | > 287 | > 450 | ||
72 | > 300 | > 450 | ||
78 | > 312 | > 450 | ||
84 | > 325 | > 450 | ||
90 | > 337 | > 450 | ||
96+ | > 350 | > 450 | ||
Action | Start phototherapy | Perform an exchange transfusion unless the bilirubin level falls below threshold while the treatment is being prepared |
Measure and record the serum bilirubin level urgently (within 2 hours).
Phototherapy that is given with an increased level of irradiance with an appropriate spectrum. Phototherapy can be intensified by adding another light source or increasing the irradiance of the initial light source used.
Phototherapy given using an artificial light sources with an appropriate spectrum and irradiance. This can be delivered using light-emitting diode, fibreoptic or fluorescent lamps, tubes or bulbs.
Glossary
direct antiglobulin test – also known as the direct Coombs' test – used to detect antibodies or complement proteins that are bound to the surface of red blood cells
end-tidal carbon monoxide
intravenous immunoglobulin
Paths in this pathway
Pathway created: May 2011 Last updated: July 2020
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