Jaundice

What Is Jaundice?

Jaundice (icterus) is the yellowish discoloration of the skin, sclera (whites of the eyes), and mucous membranes caused by elevated bilirubin levels in the blood (> 2.5–3.0 mg/dL), indicating underlying hepatic dysfunction, biliary obstruction, or hemolytic anemia.

Why Jaundice Matters on the Fireground

Recognizing jaundice during EMS assessment alerts prehospital providers to acute liver failure, hepatitis, gallbladder disease, or severe hemolysis. In trauma, jaundice combined with right upper quadrant tenderness may point to liver laceration or biliary trauma.

Relevant NFPA Standards

• NREMT Standards: National Registry of Emergency Medical Technicians Practice Standards
• NFPA 455: Standard for Emergency Medical Services (EMS)

Field Procedures & Tactical Steps

1. Inspect sclera, under the tongue, and skin under natural light for yellow discoloration.
2. Palpate abdomen for right upper quadrant (RUQ) tenderness, hepatomegaly, or ascites.
3. Obtain clinical history regarding alcohol use, hepatitis risk factors, gallstones, or recent toxic ingestions (acetaminophen toxicity).
4. Assess for encephalopathy signs: confusion, asterixis (flapping tremor), or altered mental status.
5. Document findings on ePCR and report suspected liver failure or sepsis to the receiving hospital.

Common Context & Application

Observed during primary/secondary EMS physical exams on patients presenting with abdominal pain, altered mental status, weakness, or dark urine.

Frequently Asked Questions about Jaundice