ABSTRACT
The ‘back to sleep’ campaign and a recent reduction in the rate of SUDI have led to a rigorous investigation of infants who die suddenly and unexpectedly. To avoid post-mortem autolysis, investigation should not be delayed, yet it should be undertaken with due sensitivity. Guidelines for management
Break the news to the parents. Explain the urgency of the investigations and the obligation to inform the Coroner.
Inform Coroner and obtain permission to undertake the investigation.
Samples (see following section on guidelines for laboratory investigation).
Take a full history, including a detailed account of the final 24 h.
Perform a clinical examination, including fundoscopy. Measure rectal temperature using a low-reading thermometer. Rigor mortis may be detectable in the small muscles of the face within 6 h of death.
Radiology – full skeletal survey.
Check the child protection register.Inform GP, health visitor and health records department (hospital and community) so that appointments can be cancelled.
Document all specimens taken, label them and ensure that there is an unbroken chain of evidence for forensic specimens. Record the sites from which specimens were taken.
<target id="page_227" target-type="page">227</target>Immediate bereavement supportEncourage the parents to hold the baby.
Explain to the parents about sudden infant death. Then explain that the Coroner has a duty to investigate allsudden and unexpected deaths, that they may have to make a statement to the Coroner’s Officer who will visit the home and may wish to examine the infant’s room and bedding,and that the Coroner will ask for an autopsy to be performed.
Offer to take a photograph of the infant for the parents, and suggest that they might take a lock of hair and handprints and/or footprints.Offer support and advice about the autopsy, the arrangements for the body in the meantime, funeral arrangements, registration of death, etc. This information should be provided inwritten form.
Ensure that the parents are aware of the Foundation for the Study of Infant Deaths (for address, see below) for support and information, and provide them with a copy of the Information for Parents leaflet.
Arrange for appropriate follow-up to provide ongoing support, to explain the autopsy results and to advise about the Care of the Next Infant (CONI) programme.
The Foundation for the Study of Infant Deaths, Artillery House, 11–19 Artillery Row, London SW1P 1RT. https://www.niso.org/standards/z39-96/ns/oasis-exchange/table">
Enquiries:
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Email:
fsid@sids.org.uk
