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Rapid response process in sudden unexpected death of children in a district general hospital setting—an audit of successful local practice model
  1. H Chakraborty1,
  2. J Buck1,
  3. N Rycroft2
  1. 1Paediatrics, Ipswich Hospital NHS Trust, Ipswich, UK
  2. 2Community Paediatrics, Suffolk Primary Care Trust, Bury St Edmunds, UK

Abstract

Background “Working together to Safeguard Children”, 2006 sets out national standards and procedures for investigation, management and reviews of child (0–18 years) deaths. The Royal College of Paediatrics and Child Health published guidance for the child death review process in 2008 and Local Safeguarding Boards have adopted different models. In our Trust the model of rapid response to child deaths is led by six acute Paediatricians which has posed challenges but has had many benefits.

Aims To assess the performance and practice of our local “rapid response team” against national standards.

Methods Audit tool for Rapid response—appendix 13 of “Preventing Childhood Deaths” research report 2008 was used to collect data and analysed.

Results 15 children deaths were reviewed between April ‘08 and September ‘09. Seven out of 15 (7/15) were children <1 year old. The team was notified in 13/15 cases within 2 h,1/15 between 2–24 h and 1/15 within next working day. Acute paediatricians took the initial history on 12/15 occasions and examined the child on 12/15 cases. All the appropriate investigations were carried out according to protocol on 10/15. The rest were not done due to rigor mortis and inability to obtain blood. Families were given information about the rapid response process on 14/15 occasions. Early multi-agency information sharing and planning meeting were held in all cases of which 12/15 happened within 48 h. A joint multi- agency home visit by on-call Paediatrician and a Police Officer was undertaken in 10 deaths, nine of which happened on same day. Five deaths were outside the home. There was involvement at some point of the named Consultant for all the patients previously known to the department. A final case discussion took place in 15/15 cases, of which nine were within 2 months and 6 between 2–4 months. These discussions were attended by acute paediatricians (11/15) and SUDI (sudden unexpected death in infancy) paediatrician in 11/15.

Conclusion This model of team of on-call acute paediatricians carrying out the rapid response process has proved workable and has been welcomed by statutory agencies and affected families. In addition, the National SUDIC (sudden unexpected death in childhood) protocol has been followed appropriately. Acknowledgement—Mrs Allison Batchelor

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