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Can you make a flowchart on approach to neonatal Jaundice decision making in flowchart simply

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A clean, professional medical flowchart titled "Approach to Neonatal Jaundice - Decision Making" with the following flow: START: "Newborn with Jaundice" at the top First decision diamond: "Age of onset of jaundice?" - Left branch: "< 24 hours" → box: "PATHOLOGICAL JAUNDICE - Urgent workup" → box: "Investigations: Blood group, Coombs test, CBC, Bilirubin (total & direct), Peripheral smear, Reticulocyte count" - Middle branch: "24 hrs - 2 weeks" → box: "Assess clinically" - Right branch: "> 2 weeks" → box: "PROLONGED JAUNDICE - Check direct bilirubin" From "Assess clinically" → diamond: "Measure Total Serum Bilirubin (TSB) / Transcutaneous Bilirubin (TcB)" Then diamond: "TSB above treatment threshold? (per AAP nomogram based on age in hours + risk factors)" - YES branch → diamond: "Direct/Conjugated bilirubin > 1 mg/dL?" - YES → box: "CONJUGATED HYPERBILIRUBINEMIA - Evaluate for: Biliary atresia, Neonatal hepatitis, Metabolic disease, Infections (TORCH, sepsis)" - NO → box: "UNCONJUGATED HYPERBILIRUBINEMIA" → diamond: "Coombs Test (DAT)?" - POSITIVE → box: "Hemolytic: ABO/Rh incompatibility, Other alloimmune" → box: "Phototherapy ± IVIG; Consider exchange transfusion if severe" - NEGATIVE → diamond: "Evidence of hemolysis? (low Hb, high retic, abnormal smear)" - YES → box: "Non-immune hemolytic: G6PD deficiency, Hereditary spherocytosis, etc." → box: "Phototherapy; Treat underlying cause" - NO → box: "Non-hemolytic causes: Physiological, Breastfeeding jaundice, Breast milk jaundice, Polycythemia, Extravascular blood" → box: "Phototherapy as per threshold" - NO branch → box: "Below treatment threshold" → box: "Continue monitoring; Reassess TSB in 4-24 hours based on age and risk" From Prolonged Jaundice → diamond: "Elevated direct bilirubin?" - YES → box: "Evaluate: Biliary atresia (URGENT - refer), Metabolic screen, Liver function tests" - NO → box: "Causes: Breast milk jaundice, Hypothyroidism, Hemolysis" → box: "TFTs, G6PD, Hb electrophoresis" Bottom boxes: "PHOTOTHERAPY INDICATIONS: Per AAP hour-specific bilirubin nomogram" "EXCHANGE TRANSFUSION: TSB ≥ 5 mg/dL above phototherapy threshold OR signs of acute bilirubin encephalopathy" Use color coding: Red for urgent/pathological, Yellow/amber for phototherapy, Green for monitoring, Blue for investigations. Clean lines, professional medical style, easy to read fonts, white background.

Neonatal Jaundice Decision Flowchart
Here's your neonatal jaundice decision-making flowchart. It covers the full clinical approach:
Key decision points included:
  1. Age of onset - the first and most important question
    • < 24 hours = always pathological, urgent workup
    • 24 hrs to 2 weeks = measure TSB/TcB, compare to nomogram
    • 2 weeks = prolonged jaundice, must rule out conjugated cause
  2. TSB vs threshold - based on the AAP hour-specific nomogram with risk factors
  3. Direct vs indirect bilirubin - separates conjugated (liver/biliary pathology) from unconjugated causes
  4. Coombs test - distinguishes immune-mediated hemolysis (ABO/Rh) from non-immune hemolysis (G6PD, spherocytosis) and non-hemolytic causes
  5. Treatment decisions - phototherapy thresholds and exchange transfusion criteria
Color coding:
  • 🔴 Red = urgent/pathological pathways
  • 🟡 Amber = phototherapy decisions
  • 🟢 Green = monitoring pathways
  • 🔵 Blue = investigation boxes
Let me know if you'd like any section expanded, modified, or a separate flowchart for phototherapy thresholds specifically.
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