sids training for mortuary professionals. needs sids education to be provided to all persons who may...
TRANSCRIPT
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SIDS Trainingfor
Mortuary Professionals
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Needs
SIDS education to be provided to
all persons who may interact with parents
and caregivers following a SIDS death.
(SB1068, passed in 1989)
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Needs
Education may be offered
• As an awareness training and/or
• In the form of current educational materials on SIDS issues
(SB1068, passed in 1989)
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Objectives• Define a SIDS death• Describe a typical SIDS baby• Identify the role of the coroner and the
public health nurse in a SIDS event• List four signs of grief• List two ways to provide support to
parents after a SIDS death• List two things to keep in mind when
discussing a SIDS death with children
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Definition ofSudden Infant Death Syndrome (SIDS)
• The sudden and unexpected death of an apparently healthy infant usually under one year of age which remains unexplained after a:• complete medical history• death scene investigation• postmortem examination
SIDS is a Diagnosis of Exclusion
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What We Know
• The cause(s) of SIDS remain unknown
• SIDS cannot be predicted or prevented
• No one is to blame for a SIDS death• Not parents• Not caregivers• Not emergency personnel or other health
care providers
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What Happens
• Baby is usually healthy or may have had sniffles or cold
• Baby is put down for nap or night
• Found dead minutes to hours later
• No sign of struggle or distress
SIDS can happen in any family
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Facts about SIDS
• The leading cause of death in infants between one month and one year of age in the U.S.
• Happens in about one of every 1000 live births
• Happens most often between two and four months of age
• Happens most often in winter
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SIDS is Not Caused by:
• Suffocation
• Vomiting or choking
• Child abuse
• Disease or illness
• Immunizations
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Physical appearance of SIDS infant
• Exhibits no external signs of injury• Exhibits a “natural” appearance of a dead baby:
• Lividity—settling of blood, frothy drainage from nose/mouth
• Small marks, e.g., diaper rash may look more severe
• Cooling/rigor mortis—takes place quickly in infants, in as little as three hours
Difference Between SIDS and Child Abuse
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Difference Between SIDS and Child Abuse
Physical appearance of SIDS infant • Infant appears to be well developed
• Other siblings seem normal and healthy
May initially suspect SIDS:
Some of the characteristics previously noted plus parents report that the infant was well and healthy when put to sleep (last time seen alive)
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Difference Between SIDS and Child Abuse
Distinguishable and visible signs of injury in infants less than one year of age• Broken bone(s)• Head trauma e.g., black eyes• Bruises• Scars• Burns• Welts• Cuts• Wounds
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Difference Between SIDS and Child Abuse
Signs of Child Abuse• May be obviously wasted away—malnourished
• Other siblings may show patterns of injuries commonly seen in child abuse and neglect
May initially suspect child abuse/neglect:
Some of the characteristics previously noted plus parents’ story does not “sound right” or cannot account for all injuries on the infant
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Maternal Risk Factors
• Young—less than 19 years of age
• Tobacco use doubles the risk of SIDS
• Substance use is associated with increased risk
• Limited or late prenatal care
• Short intervals between pregnancies
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Infant Risk Factors for SIDS
• Male gender
• Infant age
• Low birth weight
• Multiple births
• Premature birth
Babies can die of SIDS without having risk factors
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Multifactorial SIDS Theory
Infant’sPhysiologicResponses
Development Environment
SIDS
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Infant’s Physiologic Responses
• Oxygen reduced, carbon dioxide increased
• Arousal response deficit
• Subtle brainstem dysfunction
• Slow development
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Development—age vulnerability
• 2-4 months—75%
• 4-6 months—15%
• Respiratory system is unstable in all infants
• May take less of an environmental stress to trigger SIDS at this age.
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Environmental Factors
• Sleep position• Smoking• Temperature• Bedding• Swaddling• Season• Minor respiratory symptoms• Drug use• Poverty• Limited prenatal care
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9 Ways to Reduce the Risk of SIDS1. Always place a baby on his/her Back to Sleep,
even for naps.
2. Never allow smoking around a baby.
3. Place a baby on a firm, flat surface to sleep.
4. Remove all soft things such as loose bedding, pillows, and stuffed toys from the sleep area.
5. Never place a baby on a sofa, waterbed, soft chair, pillowor bean bag.
6. Take special precautions when a baby is in bed with you.
7. Make sure a baby doesn’t get too hot.
8. Keep baby’s face and head uncovered during sleep.
9. Share this information with everyone who cares for a baby.
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When SIDS Happens
• Baby found not breathing
• Call is made to 911
• EMS, fire or police respond
• Decision is made about CPR and transport
• Baby is pronounced dead
• Coroner goes to the death scene, home or hospital
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Coroner’s Responsibilities
• Investigate death scene
• Obtain complete medical history
• Have autopsy performed
• Contact county health department
• Notify parents of apparent cause of death
• Inform California SIDS Program
• Sign death certificate
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Local Health Department Responsibilities
• Contact family/childcare provider within three working days
• Services to be provided:• Assess family, childcare provider/foster
parent or both • Crisis intervention and counseling • Referral to community services• Follow-up care to assess progress
• Submit report of contact to the California SIDS Program
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A SIDS Death is Different From Any Other Death Within a Family
• Babies are not supposed to die. The family expected that the baby would grow up and outlive them.
• The death is sudden. The family had no reason to expect that the baby would die.
• The death is incomprehensible. The designation of SIDS tells the family that no medical explanation for their baby’s death was found.
Each of these factors will have an influence on the family member’s grief
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When a Baby Dies
It is stressful for everyone:
• Parents
• Family
• Professionals providing care
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At the Initial Encounter Tell the Parents
• Who you are
• That you know
• That you care
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Remember
• What you can do
• What you cannot do
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You Can Make a Positive Difference for the Parents
Parents vividly remember
the first moments after they
are told the baby died
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You Can Convey Caring
Give permission to grieve:
• Acknowledge their loss• Accept expressions of grief• Express your own griefOffer continued support:
• Provide information• Link the family with other parents• Develop a follow-up plan
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How to Convey Caring
• Be there to listen
• Allow expressions of grief
• Encourage the family to talk about the baby
• Give special attention to the baby’s brothers and sisters
• Help identify family and friends who may help
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What You Cannot Do
• Take away the pain
• Bring the baby back
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Things that Hurt• Saying you know how they feel• Saying You ought to...• Not using the baby’s name• Offering platitudes• Saying they have other children or can
have more children later• Suggesting that the baby did not have
good care• Being suspicious and judgmental
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Preparing Yourself
Experience fully your own losses.
Otherwise, the losses of others will
become a mirror of your own.
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The Tasks of Grieving
• Accepting the reality of the loss
• Experiencing the pain of grief
• Adjusting to a life without the baby
• Moving on
—Dr. J. W. Worden
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Professional Reaction
Signs and Symptoms of Critical Incident Stress• Recurring dreams• Anger • Physical illness• Depression• Changes in eating and sleeping patterns• Mood changes• Inability to concentrate• Withdrawal
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Stress Relief
• Limit overtime hours• Exercise• Plan leisure time• Get adequate rest• Eat a balanced diet• Write down what bothers you• Get professional, religious, or peer counseling• Talk about what happened
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Resources
Local Health Department
_________________________
Local Bereavement Support Group
_________________________
California SIDS Program
800-369-SIDS (7437)
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California SIDS Program
This PowerPoint presentation is copyrighted, but may be reproduced without permission. We request that proper credit be given to: California Department of Health Services/
California SIDS Program
Produced by the California SIDS Program under funding by the California Department of Health Services, Maternal, Child and Adolescent Health Branch © 2005
California Sudden Infant Death Syndrome Program800-369-SIDS (7437) • www.californiasids.com