Identifiable risks requiring the immediate referral and transport of a newborn shall include the following:

1. (a) Respiratory rate greater than 80 or grunting, flaring, or retracting following delivery with meconium-stained fluid;
2. (b) central cyanosis or pallor for more than 10 minutes;
3. (c) Apgar score of six or less at five minutes of age;
4. (d) abnormal bleeding;
5. (e) more than eight hours of continuous postpartum evaluation;
6. (f) vesicular skin lesions;
7. (g) seizure-like activity;
8. (h) poor feeding effort due to lethargy or lack of interest for more than two hours immediately following birth;
9. (i) temperature less than 96.8 degrees Fahrenheit or greater than 100.4 degrees Fahrenheit documented more than 15 minutes apart;
10. (j) heart murmur lasting more than 24 hours immediately following birth;
11. (k) cardiac arrhythmia;
12. (l) congenital anomalies;
13. (m) failed critical congenital heart disease screening;
14. (n) birth injury;
15. (o) clinical evidence of prematurity, including low birth weight of less than 2,500 grams, smooth soles of feet, or immature genitalia;
16. (p) jaundice in the first 24 hours after birth or significant jaundice at any time;
17. (q) no stool for more than 24 hours immediately following birth;
18. (r) no urine output for more than 24 hours; and
19. (s) development of persistent poor feeding effort at any time.

(Authorized by K.S.A. 65-28b07; implementing K.S.A. 65-28b02, 65-28b07; effective Jan. 10, 2020.)