By Allison G. S. Knox, EMT-B, Faculty Member at American Military University
It isn’t rare for newborn babies to have trouble with jaundice in the days after their birth. The condition is usually recognizable by an orange coloring of the skin, which is caused by a high level of bilirubin in the blood. Most of the time the baby’s liver will rid the body of bilirubin, but in rare cases, the bilirubin level rises so quickly that their body simply cannot recover, resulting in devastating effects.
When the level is high enough, bilirubin crosses the blood-brain barrier and leaves a stain on the brain that causes brain damage, a condition called kernicterus. Untreated severe hyperbilirubinemia can also cause auditory neuropathy spectrum disorder, ranging from mild to complete hearing loss, and cerebral palsy, which leaves a child unable to walk. Many of these children are forced into wheelchairs for life. For some, severe hyperbilirubinemia can even result in death. Once caused, the damage from hyperbilirubinemia cannot be reversed, but the cognitive parts of the brain are often left intact. For the family of a child with kernicterus, it can be devastating to see their child who was perfectly healthy at birth suddenly suffer from a debilitating illness.
[Related: Zika Virus and EMS Patient Assessment]
Changing Medical Policies
To effectively manage jaundice and detect hyperbilirubinemia in newborn babies, healthcare policies are in urgent need of change. Because potentially devastating levels of bilirubin are so rare, many doctors don’t necessarily look out for the signs and symptoms that can arise in the first few days of a newborn’s life. As a result, a child who could be helped is often left untreated. If bilirubin levels were regularly checked through physician-ordered tests, fewer babies would suffer from kernicterus.
Healthcare organizations must require physicians to order bilirubin tests at the early signs of jaundice. Doing so would likely detect rising levels of bilirubin earlier, which would initiate immediate treatment and ultimately prevent kernicterus. Fortunately, bilirubin tests are not expensive, which should encourage physicians and parents to test for this life-threatening condition. Medical professionals have been advocating for changes to the protocol for neonatal bilirubin testing for more than 10 years, but many healthcare organizations have still not heeded their advice. Instituting this relatively simple and inexpensive test on newborns could save lives and prevent otherwise healthy babies from suffering the horrendous, yet completely preventable, condition.
About the Author: Allison G. S. Knox is on the faculty at American Military University. An emergency medical technician and a political scientist, Allison’s research interests are comprised of federalism and emergency management/emergency medical services policy issues. Prior to teaching, Allison worked in a level one trauma center emergency department and for a member of Congress in Washington, D.C. She holds four master of arts degrees in emergency management, international relations, national security studies and history. She also holds a graduate certificate in homeland security, a bachelor of arts in political science and is working on her doctorate. Allison currently serves as the Chapter Sponsor and Faculty Adviser for the West Virginia Iota Chapter of Pi Gamma Mu International Honor Society, is the Faculty Advisor for the Political Science Scholars and also serves as the Chancellor of the Southeast Region on the Board of Trustees for Pi Gamma Mu International Honor Society.