TYPE OF PACKAGE VARIES AND IS NOT INCLUDED IN THE PRICE OF THE ICTEROMETER. THE ICTEROMETER ITSELF IS $20, IF YOU RECEIVE A POUCH, IT IS CONSIDERED FREE. LEATHER POUCHES NO LONGER USED.
Directions for Use
Press the back side of the icterometer against baby's nose or forehead (for lighter skinned babies) or against the inside of the baby's lip (if baby is African-American or other very dark skinned ethnicities). Gentle pressure applied to the icterometer will blanch baby's skin, allowing you to match the hue of the skin to the swatches, skin hues in between the colors of the swatches are assigned half numbers on the icterometer grade key, e.g., visual readings between color swatch 3 and 4 will be read as 3 1/2. The values to the right of the icterometer grade will allow you to estimate baby's bilirubin levels. These estimates allow you to monitor the progression of jaundice and alert you to levels that require blood sampling.
Caring for Your Icterometer
The acrylic icterometer can be easily scratched, so wrap it in a soft cloth or leather carrying bag, pouch or case when not in use. Use a mild soap and water to clean your icterometer between each use. Avoid bleach, sterilizers, heating or other disinfection methods as they will damage the acrylic and compromise the paint color.
The clear acrylic tool has five painted yellow strips, varying in shades from light (1) to Dark (5). Adjacent to the color swatches are three tables that allow you to correlate the visual test with estimated bilirubin levels:
Icterometer Grade /Numbers and half numbers assigned to color swatches
Serum Bilirubin Mean /Mean level of total serum estimated to be present
MG% Indirect +2 S.D. /Range (+/-2 standard deviation) of statistically normal indirect serum bilirubin estimated to be present.
- For best results use the icterometer under natural, full-spectrum or incandescent light, not recommended for use under fluorescent light sources. It cannot be used on bruised, broken, or abnormally pigmented skin (e.g. Sturge-Weber syndrome). In these instances, use the icterometer on an unaffected skin area.
- In some instances, the icterometer should not be used as a first screen for blood sampling. The manufacturers of the icterometer caution every care provider to be aware of the rapid onset and/or increase of neonatal jaundice. If baby shows signs of jaundice within 35 hours of birth, you should ALWAYS order a serum bilirubin blood test.8
History and Clinical Efficacy of the Icterometer
First manufactured in 1954, icterometer were developed as a means to monitor the daily progression of newborn jaundice.1 Today, they are used in birth clinics, public health clinics, hospitals, community nursing programs and in private practice as a cost-effective, clinically accurate screening tool.
Although electronic transcutaneous bilirubinometers exist as an alternative and modern non-invasive screen, they have not been shown to be significantly more accurate than the icterometer,2,3 and they are much more costly. In fact, numerous recent studies have demonstrated the icterometer's efficacy and usefulness as a screening tool for determining when to obtain newborn serum bilirubin (SB).4,5,6,7
1 Thos. A. Ingram & Co. Ltd. A Perspex Icterometer for Neonates. Page 2; 1960.
2 Schumacher RE, Thornberry JM, Gutcher GR. "Transcutaneous bilirubinometry: a comparison of old and new methods" Pediatrics. July, 1985. (1): 10-4.
3 Bhardwaj HP, Narang A. Bhakoo ON. "Evaluation of Minolta jaundicemeter and icterometer for assessment of neonatal jaundice." Indian Pediatr. February, 1989. (2): 161-5.
4 Madlon-Kay, Diane J. "Recognition of the Presence and Severity of Newborn Jaundice by Parents, Nurses, Physicians, and Icterometer." Pediatrics. Vol. 3, page e3; September, 1997.
5 Madlon-Kay, Diane J. "Home health nurse clinical assessment of neonatal jaundice: comparison of 3 methods." Archives Pediatric & Adolescent Medicine. 2001. (155): 583-586.
6 Madlon-Kay, Diane J. "Maternal assessment of neonatal jaundice after hospital discharge." Journal of Family Practice. May 2002.
7 Morantz, Carrie and Torrey, Brian. "AHRQ report on neonatal jaundice." American Family Physician. June, 2003.
8 Thos. A. Ingram & Co. Ltd, ibid.