Dräger JM-105 - Page 9

9
Dräger Jaundice Meter JM-105
Data Collection Sheet
Please write your Jaundice Meter SN #: ____________________________
Site for all Jaundice Meter measurements:__________________________
- Patient #
- Hours of Age &
- Race or Skin Color
JM-105
reading
TcB
Time / Date
JM-105
Reading
taken*
Serum
Bilirubin
analysis
Result
TSB
Time/ Date
blood
sample
drawn*
Staff Initials and
Comments:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
*The time gap between the Jaundice Meter JM-105 readings and the blood sample should not be greater than one hour.
MU25261_3_RI05/ 10.2017/ Printed in United States / Chlorine-free – environmentally compatible / Subject to modifications / ©Draeger Medical Systems, Inc.