HamzeH HarayzeH

الحرايزة حمزة

التمريض كلية

والتكنولوجيا العلوم جامعةاالردنية

Outline

Objective Pathophysiology Proposed Causes and Symptoms Risk factor Prevention Nursing managment

Objective

After we finished presentation you have able to :

Discuss about sudden infant death syndrome and pathophysiolgy

Know Risk factor for SIDS Learn about prevent methods and co-sleeping. Learn about management and nursing process

Definition of SIDS

The sudden and unexplained death of an infant under one year of age. – Leading cause of death in infants under 12 months

Triple risk hypothesis : Vulnerable infant Critical developmental period in homeostatic

control Exogenous stressors

path physiology

Proposed Causes (External/Internal)

Tiny hemorrhages Asphyxiation Immune System

Disorders Apnea Hypothesis

Sleep position Temperature Smoke/Narcotics Bedding

Sleep Position

The baby is in the prone position (Lying on its stomach)

Temperature

The temperature of the environment would determine how warmly the infant is dressed or how tightly a blanket is wrapped around the infant.

Smoke/Narcotics

The presence of smoke during pregnancy increases the infants chance 3 times for having SIDS.

The use of narcotics during pregnancy increases the infants chance 10 times for having SIDS.

Bedding

Improper bedding such as a too soft mattress or a big fluffy blanket could cause the infant to inhale stale air during the night.

Tiny Hemorrhages

Autopsy’s revealed that tiny hemorrhages inside of the babies chest could be responsible for congestion in the lungs during the night.

Asphyxiation

Asphyxiation by carbon dioxide is associated with soft bedding because the infant only breathes in stale air (containing mostly carbon dioxide) throughout the night, and does not receive the proper amount of oxygen.

Immune System Disorders

Infants who have an immune system disorder are at higher risk than those who do not, because it is likely to cause a change in heart rate during the night.

Apnea Hypothesis

The cessation of airflow to the nose and mouth (central apnea)– The pause is called central and usually last for

about 15 seconds

Most widely accepted hypothesis

Sleep Apnea Hypothesis

There is an abnormality in the regulation of the breathing activity that leads to prolonged central apnea, hypoxia which leads to coma, death

Treatment

Because SIDS has no known cause and happens randomly there is no treatment available.

Prevention

Lying the infant on its back during sleep Proper bedding Controlled environment temperature Good prenatal care Avoidance of smoke and narcotics Monitors Co-sleeping with parents

Co-Sleeping

Co-sleeping is widely believed to be a prevention of SIDS

What does Co-sleeping do?

Allows for the mother and infant to interact their breathing patterns.

Exchange sensory stimuli such as sound, movement, touch, vision, gas, and temperature.

Infants spend less time in the deep stages of sleep. Allows the baby to be near the mother for breast

feeding during the night.

Breast feeding

Human milk provides less calories than formula, which indicates the need for more frequent feedings.– More frequent contact with mother

Natural Selection and SIDS

When an infant is separated from its caregiver, its natural instinct is to protest (cry).

Natural selection probably favored the infants who protested.

Summary

There is no known cause or treatment for SIDS. Although there is action that can be taken for the prevention of SIDS. Co-sleeping and breast feeding, under proper conditions, are the two most significant prevention techniques.

In addition to loss of infant, families face could face police investigation, long wait for autopsy results and continued uncertainty leading to prolonged emotional distress consequently affecting the grieving process

Physician can play active role by advocating for an autopsy, discussing autopsy results with the family and providing emotional support

Surviving siblings and other family members need age appropriate emotional support

If appropriate refer family for genetic counselling and/or metabolic testing

Direct family to local counselling and support groups

Management and support

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Nursing Dx with SID

Dysfunctional grieving Fear Hopelessness Interrupted family processes Spiritual distress

Nursing Outcomes Nursing Care Plans For Sudden Infant Death Syndrome SIDS

Family members will seek appropriate support persons for assistance.

Family members will use available support systems to assist in coping with fear.

Family members will identify feelings of hopelessness regarding the current situation.

Family members will share feelings about the event. Family members will verbalize measures to prevent

SIDS. Family members will use effective coping strategies to

ease spiritual discomfort.

Nursing Interventions NCP Nursing Care Plans For Sudden Infant Death Syndrome SIDS

Grief Work Facilitation: Assistance with the resolution of a significant loss Grief Work Facilitation: Perinatal Death: Assistance with the resolution of

a perinatal loss Coping Enhancement: Assisting a patient to adapt to perceived stressors,

changes, or threats that interfere with meeting life demands and roles Anxiety Reduction: Minimizing apprehension, dread, foreboding, or

uneasiness related to an unidentified source or anticipated danger Security Enhancement: Intensifying a patient’s sense of physical and

psychological safety Hope Instillation: Facilitation of the development of a positive outlook in a

given situation Emotional Support: Provision of reassurance, acceptance, and

encouragement during times of stress Family Process Maintenance: Minimization of family process disruption

effects

Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet. Nov 3 2007;370(9598):1578-1587.

Weese-Mayer DE, Ackerman MJ, Marazita ML, Berry-Kravis EM. Sudden Infant Death Syndrome: review of implicated genetic factors. Am J Med Genet A. Apr 15 2007;143A(8):771-788.

Gurbutt D, Gurbutt R. Risk reduction and sudden infant death syndrome. Community Pract. Jan 2007;80(1):24-27.

Fleming P, Blair PS. Sudden Infant Death Syndrome and parental smoking. Early Hum Dev. Nov 2007;83(11):721-725.

Damato EG. Safe sleep: can pacifiers reduce SIDS risk? Nurs Womens Health. Feb 2007;11(1):72-76.

Haycock G. Recent research in sudden infant death syndrome. J Fam Health Care. 2007;17(5):149-151.

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