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Set Up of Phototherapy Unit
Phototherapy generally consists of four to eight cool white, day bright, or special blue fluroescent tube lights covered by a plastic shield and placed about 18 or 45 cm inches away from the baby. The spectrum of light at 420-460 nm is the most effective. The energy output in this spectrum should be checked periodically to ensure efficiency. The efficiency of phototherapy depends on energy output of the spectrum and on the surface area of the infant exposed to those lights.Though, blue lights are the most effective, they are not widely used because they mask the clinical signs of cyanosis and colour change in the infant. While light permits better visual monitoring. The plastic shield absorbs ultra-violet irradiation. A photo-reaction occurs in the very outer layers (top 2 mm) of the skin. Once phototherapy has been initiated, serum levels of bilirubin must be monitored frequently (every 4-12 hours) because visual assessment of icterus is no longer valid.
Place the infant naked under the lights with shielding over the eyes. A small cloth may be placed for scrotum protection in male babies the infant's position should be changed frequently. This permits maximal skin exposure to the lights. Make sure that baby is 18 inches or 45 cm away from light.
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