SUDIC Protocol

All infants found collapsed or dead should be taken to ED.

definition

Sudden = no reason to suspect in prior 24h
Unexpected = no apparent medical cause of death
Death in
Infancy - <24 months (<12 months = SIDS)
and Childhood - >24 months

risk factors

No one risk factor can prevent.
Triple Risk hypothesis:

  1. undetected vulnerability
  2. critical stage of development e.g. 6 months
  3. external factor = physiological stressor

safe sleeping

  • environment

    • sleep with parents in same room (but not in same bed generally)
    • no excess clothing or bedding
    • avoid overheating - radiators/direct sunlight

  • sleep on back, feet at end of cot

  • low birth weight, IUGR, preterm

  • parental alcohol/recreational drug consumption

  • parental smoking

resuscitation in SUDIC

"why wouldn't you treat it as an arrest?" I guess most of this is retrospective too but maybe it's similar to stopping resuscitation in an adult
record BOTH time resuscitation is stopped and time that death is verified

forensic awareness

  • document ALL attempts for procedure e.g. cannulation
  • leave equipment in situ
  • ETT position must be confirmed by 2nd competent person
  • police SIO to attend

multi-agency

  • police will attend
  • social work should be informed - duty SW as first port of call

investigations after death

  • bloods including genetic testing and Guthrie spot card
  • skin biopsy - metabolic/genetic testing
  • CSF
  • NPA
  • urine
    samples must be HANDED OVER BY HAND - to keep chain of custody complete

afterward

SUDIC in a twin - the other twin usually admitted for observation
No organ donation
Child death overview panel
Home visit
Multiagency meeting

#neonates #medicolegal

RCEM Learning: https://www.rcemlearning.co.uk/modules/the-sudic-protocol/lessons/context-160/
Lullaby Trust on safe sleeping: https://www.youtube.com/watch?v=NO2vbtjNk2c&t=1s