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SUDDEN INFANT DEATH SYNDROME (SIDS). Presented by Jackie Yates-Feller, NREMT-P, PI. Objectives. Upon completion of this presentation, the student will be able to: Define SIDS Describe the general population characteristics of a probable SIDS infant - PowerPoint PPT Presentation


  • SUDDEN INFANT DEATH SYNDROME (SIDS)Presented byJackie Yates-Feller, NREMT-P, PI

  • ObjectivesUpon completion of this presentation, the student will be able to: Define SIDSDescribe the general population characteristics of a probable SIDS infantDescribe the common physical characteristics of a probable SIDS infant

  • ObjectivesDescribe the typical scenario of a probable SIDS Identify important actions which should be initiated by an emergency responderIdentify potential responses of parents to an infant deathIdentify potential responses of emergency responders to an infant death

  • ObjectivesIdentify common signs & symptoms of Critical Incident Stress (CIS)Identify strategies for decreasing the impact of Critical Incident Stress (CIS)Identify community resources available to parents

  • Definition - SIDSthe sudden death of an infant, usually under 1 year of age, which remains unexplained after a complete postmortem investigation, including an autopsy, examination of the death scene and review of the case history

  • SIDS StatisticsClassified as a disorderLeading cause of death in infants 1 month to 1 year old95% occur between 1 & 6 months of age - peak period between 2 & 4 months3,000 SIDS deaths per year in the U.S.

  • SIDS - What It IsMajor cause of death in infants after 1st month of lifeSudden & silent in an apparently healthy infantUnpredictable & unpreventableQuick death with no signs of suffering - usually during sleep

  • SIDS - What It Is NotCaused by vomiting or chokingCaused by external suffocation or overlayingContagious or HereditaryChild abuseCaused by lack of loveCaused by immunizationsCaused by allergy to cows milk

  • General Characteristics of SIDSUsually occurs in colder monthsMothers younger than 20 years oldBabies of smoking mothers or mothers exposed to second hand smoke60% male Vs 40% femalePremature or low birth weightUpper respiratory infections, 60% in prior weeksOccurs quickly and quietly during a period of presumed sleep

  • SIDS ResearchEvidence shows victims not as normal as they seemMaybe subtle but, undetectable, defects present at birthAreas presently under researchBrain abnormalitiesSleep positionMultiple, non-life threatening abnormalities

  • Medical Findings Consistent With SIDSDifferences seen in external appearance versus internal appearance seen on autopsy.

  • External AppearanceNormal state of hydration & nutritionSmall amount of frothy fluid in or about mouth & noseVomitus presentPostmortem lividity &/or rigorsLivormortis Disfiguration/Unusual position - dependant blood pooling/pressure marks

  • Internal Appearances On AutopsyPulmonary congestion & edemaIntrathoracic petechiae 90% of timeStomach contents in tracheaMicroscopic inflammation in trachea

  • Typical SIDS Infant ScenarioAlmost always occurs during sleep or appearance of sleepUsually healthy prior to deathMay have had a cold or recent physical stressMay have been place down for nap, found not breathing or appearing deadParents not hearing signs of struggle

  • Emergency Responder ActivityInitiate resuscitation per department procedures and guidelines

  • Emergency Responder Activity Cont.Support of ParentsUse calm directive voiceBe clear in instructionsProvide explanations about Tx & transportReassure that there was nothing that they could have doneDo not be afraid of tears & angerAllow parents to accompany infant to hospital if situation permits

  • Emergency Responder Activity Cont.Obtain HxIllicit medical historyListen to the parentsDo not ask judgmental or leading questionsUse open-ended & non-leading questionsHad infant been sick

    What happened Who found the infant & where What did (s)he doHad the infant been movedWhat time was infant last seen & by whomHow was infant that dayLast feeding

  • Environmental AssessmentObserve forLocation of infantPresence of objects in area infant foundUnusual conditionsHigh room temperatureOdorsAnything out of ordinary

  • Anticipated Parental ResponsesNormal responses may include:Denial, shock and disbeliefAnger, rage and hostilityHysteria or withdrawalIntense guiltFear, helplessness and confusionNo visible responseMay or may not accept infants death

  • Expected Requests From ParentsRepetitive questionsRequest to not initiate careRequest to be alone with infantRequest to terminate resuscitation effortsRequests for cause of death

  • If Parents Interfere With CareShow empathyDo not become angered or argumentativeAvoid restraining parentBe professional - put yourself in their shoes

  • Emergency Personnel ResponsesWithdrawal, avoidance of parentsSelf-doubtAnger - wanting to blame someoneIdentification with parentsSadness & depression

  • Emergency Responder Expectations of Parents BehaviorHysterical & tearful responsesDisbelief that not every parents will initiate CPRDisbelief/unable to accept parents decision to not have CPR startedCultural differences in mourning and grieving process

  • Critical Incident Stress (CIS) ManagementStress is an integral part of the profession of Emergency Services

  • Signs & Symptoms of CISAnger/irritabilityPhysical illnessDepressionRecurring dreamsIntrusive imagesChanges in sleep patterns Mood changes/swingsWithdrawalChanges in eating habitsInability to concentrateRestlessness/agitationLoss of emotional controlIncreased alcohol consumption

  • Strategies for Decreasing Impact of CISTalk to your peers/ share your feelingsExercise and balanced dietAvoid OT & plan leisure timeWrite a personal journalObtain personal or religious counselingRequest dispatch tape reviewsRequest assistance from you local CISM team, post incident

  • SIDS ResourcesNational SIDS Resource Center (703) 821-8955SIDS Alliance (800) 221-SIDS WWW.sidsalliance.orgNational Institute of Child Health &

  • ReferencesCalifornia Fire Chiefs Association, Emergency Medical Section, Sudden Infant Death Syndrome Instructor Instructor GuideApril 1991.Department of Health, Education & Welfare, Public Health Service Administration, Bureau of Community Health Services Training Emergency Responders: SIDS An Instructor Manual, DEW Publications No (HAS) 79-5253, 1979State of California EMS Authority, SIDS Training Packet For Emergency Medical Responders and Firefighters, September 1990American SIDS Institute, SIDS: Toward an UnderstandingColorado SIDS Program, Commonly Asked Questions About SIDS: A Doctors Response J Bruce Beckwith M.D. 19983 National SIDS Resource Center, Information Sheet: What is SIDS, May 1993Center for Pediatric Emergency Medicine, TRIPP 1998, Version 2

  • References Cont.National SIDS Clearing House, Fact Sheet: SIDS Information The EMTDavid Lawrence, SIDS Handle With Care JEMS, December 1988Seasonality in SIDS-U.S. 1980-1987, MMWR, December 14, 1990, Vol..39., No. 49From the CDC, Atlanta, Georgia, Seasonality in SIDS JAMA, February,13, 1991, Vol. . 265, o. 6.From The National Health Institute< Chronic Fetal Hypoxia Predispose Infants to SIDS, JAMA, December 5, 1990, Vol.. 264, No. 21.Carroll, John L. & Loughlin, Gerald M., Sudden Infant Death Syndrome Pediatric review, Vol.. 14, No. 3., March 1993Jackson, & Community Midwifery, United Leeds Teaching Hospital Trust SIDS PART 1 Definitions & Classification of SIDS, Midwifery Chronicles & Nursing Notes, August 1992

  • References Cont.Jackson, & Community Midwifery, United Leeds Teaching Hospital Trust SIDS PART 2 Definitions & Classification of SIDS, Midwifery Chronicles & Nursing Notes, August 1992Florida Emergency Medicine Foundation & California EMS Authority, Pediatric Education for Paramedics 1997American SIDS Institute, Coping With Infant Loss, Grief and Bereavement, June 1994American SIDS Institute, Helping A Friend Cope With Infant Loss, Grief and Bereavement, June 1994Parrott, Carol, Parents Grief Help & Understanding After The Death of a Baby, Medic Publishing Company, 1992Klobadans, David, First Responders and EMS Personnel - SIDS Training Outline

  • SUMMARYQuestions?