Introduction ‘Procedural Response to Unexpected Deaths in Childhood (PRUDiC)’ was completed with Ministerial approval in Wales in March 2011 and all the principles described under SUDI were extended to include all unexpected childhood deaths up to 18 years of age. PRUDiC was formally implemented in our health board in Jan 2012.
Aims 1. To look at all unexpected deaths in children and to ensure PRUDiC process was adhered to. 2. To identify any emerging themes.
Methods Prospective analysis of all paediatric deaths in Aneurin Bevan Health Board from Jan 2012–Dec 2013. Deaths in Neonatal unit were excluded.
Results There were 45 (30 in 2012 and 15 in 2013) paediatric deaths, out of which 35 were investigated as per PRUDiC protocol.
PRUDiC deaths, n = 35 (Male – 20 and female –15): Majority of deaths – 40% (14/35) were in babies <1 year of age. 60% (21/35) of children had no previous underlying medical problems. 31/35 final Post Mortem (PM) reports were available. These were unascertained (including SUDI) – 42% (13), followed by sepsis–13% (4), pressure to neck–13% (4), exposure to fire–6.5% (2), congenital heart disease–6.5% (2) and road traffic accident–3%(1).
Paediatric deaths not needing PRUDiC, n = 10 (Male – 5 and female – 5): There were 3 children in each of the following age groups – <1 year, 1–5 year & 10–17 years old. All children had underlying complex medical problems and a cause of death was identifiable.
Discussion In 5 infants where PM findings were unascertained there were risk factors like co-sleeping, alcohol consumption and sleeping in prone position. One child where PRUDiC procedure was not followed was managed by adult medical team.
Conclusions All unexpected deaths are being investigated appropriately as per PRUDiC. There are no obvious themes identified in our small sample size, however bed sharing/prone sleeping continues to be an ongoing risk factors in babies. There are ongoing delays in getting PM reports.
Recommendations Analyse data on yearly basis to look at any emerging trends. Additional targeted education regarding bed sharing to be directed to vulnerable parent groups. The responsible paediatrician to actively chase the PM reports either through the police or directly from the coroner’s office.
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