Proforma

Emergency Department Flowchart

UNEXPECTED DEATHS in INFANCY AND CHILDHOOD
Baby/Child found lifeless – Ambulance called by 999
A m b u l a n c e i n f o r ms Emergency Depar tment

Emergency Dept triage nurse receiving call, notes time, and notifies:
• Senior Emergency Dept resus team – prepares equipment and dr ugs
• Paediatric Registrar – infor ms Consultant
• N u r s e a l l o c a t e d f o r p a r e n t s ( ex p e r i e n c e d , t r a i n e d )
• Ward Clerk orders child and parent medical records from store,
for immediate deliver y

AMBUL ANCE ARRIVES EMERGENCY DEPARTMENT

Emergency Department Resus Room Parents

• Attempt resuscitation Greet at door
• Pr e l i m i n a r y Histor y Quiet room
• Pr e l i m i n a r y Examination Offer to view resuscitation accompanied
• O b t a i n l a b o r a t o r y specimens Offer Chaplain
• Rectal temperature and time
• Most senior doctor discusses with team and parents
prior to stopping resuscitation

Parents
Emergency Department Following Resuscitation:
C a r r y b a b y i n t o r o o m i n a r ms as a baby
• Senior Paediatrician declares dead and notifies
Refer to baby by name
Police/Coroner
Give baby to parents to hold but
• If Coroner agrees, may wipe face, remove ET tube (af t e r
super vise at all times
visualisation) and IV cannulae
• C o m p l e t e p a e d i a t r i c ex a m i n a t i o n
• Clothing removal must follow police protocol
• Put on clean nappy. Wrap in hospital baby blanket

Parents inter viewed by Paediatrician and Police to obtain full histor y

Consider health and child protection needs of family

Complete Documentation Caring for the Family

Complete Notification (Checklist) Mementos and photos
Procedural infor mation
Bereavement suppor t

Multi-agency strategy discussion

Parents retur n home; ar rangements for home visit

Staff debrief
 Sudden Unex p e c t e d D e a t h i n I n f a n c y - C h e c k l i s t

Child's details NAME:

DOB: DOD:

Address

Name of Paediatrician

Name of staff member supporting parent(s)

Name of Police officer in charge

ACTION Y/N/NA DATE TIME ACTIONED BY

Consultant Paediatrician called
Police Child Protection team informed
Name:
Coroner’s Officer informed
Name:
Specialist Paediatrician called
Name:
Initial history taken and recorded
Soiled or wet nappy bagged labelled and stored
Sites of vascular access during resuscutation
documented
Detailed physical examination of child
Body map I diagrams
Photographs
Samples taken sent for examination
Details:

Children’s social care enquiries made

GP Informed
HV informed
Hospital chaplain or other religious leader
contacted if appropriate
Child Health Computer and hospital
PAS system informed
Mementoes taken for parents
Hair
Footprint
Handprint
Photograph
Information on bereavement support and contact details
given to parents

• Y - YES, N- No, NA - not applicable © University of Warwick/ United Bristol Healthcare NHS Trust
Used with permission

Department for Children, Schools and Families

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London
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