Centers for Disease Control and Prevention's Sudden .ppt

1、Centers for Disease Control and Preventions Sudden Unexplained Infant Death Initiative,Terry W. Davis, EdD, EdS, MACityMatCH/NACCHO Webinar May 18, 2006,Outline of Presentation,The importance of the infant death scene investigation How the new SUIDI Reporting Form improves the overall investigation

2、The key elements of the scene Explain the SUIDI Reporting System National Training Academies,Sudden Infant Death Syndrome (SIDS),“Sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of

3、 the death scene, and review of the clinical history.”,* Willinger M, James LS, Catz C. Pediatr Pathol 1991; 11(5):677-684,Impact of SIDS and SUID,SIDS 2500 SIDS deaths per year Third leading cause of infant mortality Leading cause of postneonatal mortality SUID 4600 SUID deaths per year Accidental

4、suffocation & strangulation doubled in last decade,Sudden, Unexplained Infant Deaths (SUID),Suffocation (overlaying, choking, and wedging) Infection (sepsis, pneumonia) Metabolic and genetic causes Neglect or homicide Intoxication, poisoning Hypothermia, hyperthermia Central nervous system causes SI

5、DS,Importance of Diagnosis and Reporting,Hinders our ability to Monitor trends in SUID Conduct research to identify risk factors Design interventions to prevent SUID Evaluate programs aimed at prevention,Importance of Investigating SUID,Without a complete death scene investigation Makes it difficult

6、 to determine cause and manner-of-death Disadvantage for pathologist conducting autopsy Disadvantage for those trying court cases Hinders prevention efforts,Goals of CDCs SUID Initiative,Standardize and improve data collection at death scene Promote consistent diagnosis and reporting of cause of dea

7、th Improve and standardize reporting on death certificate Prevent SUID by using improved data to identify those at risk,Training Materials,Training Text Student Note Taking Guide Curriculum/Instructor Guide Instructional DVD On-Line Training Testing for National Certification SUIDI Reporting Form,Tr

8、aining Objectives,How to use SUIDI Reporting Form How to conduct a DSI Doll reenactmentHow to interview grieving families and caregivers How to recognize difference between SIDS, suffocation, and other SUID How to fill out a death certificate,SUIDI Reporting Form,SUIDI Top 25,1. Case Information 2.

9、Asphyxia 3. Sharing sleep surfaces 4. Change in sleep conditions 5. Hyperthermia/hypothermia 6. Environmental hazards 7. Unsafe sleeping condition 8. Diet 9. Recent hospitalizations 10. Previous medical diagnosis 11. History of acute life threatening events 12. History of medical care without diagno

10、sis,13. Recent fall or other injury 14. History of religious, cultural, or ethnic 15. COD due to natural causes other than SIDS 16. Prior sibling deaths 17. Previous encounters with police or social services 18. Request for tissue or organ donation 19. Objection to autopsy 20. Pre-terminal resuscita

11、tive treatment 21. Death due to injury, poisoning, or intoxication 22. Suspicious circumstances 23. Other alerts for pathologists attention 24. Description of circumstances (what happened?) 25. Pathologist Information (name/agency/phone),Training Content,Sudden, Unexplained Infant Deaths Infant Grow

12、th and Development Interviewing Psychology Interviewing and Investigative Data Collection Conducting Witness Interviews Conducting Scene Investigations Conducting Doll Reenactment Developing Pre-Autopsy Report Certification of Unexplained Infant Deaths,Infant Death Investigation Guidelines,Investiga

13、tive Tools and Equipment Arriving at the Scene Documenting and Evaluating the Scene Establishing Infant Profile Information Completing the Scene Investigation,SUIDIRS.NET,Sudden, Unexplained Infant Death Investigation Reporting SystemInternet-based critical data reporting system. Allows investigator

14、s to “upload” scene data at any location with internet access. Allows forensic pathologists (who receive body) to “download” scene data at their location before beginning the autopsy. Stores data in national data base for surveillance and prevention activities.,SUIDI Academies,Midwest National SUIDI

15、 Training Academy March 13-17, 2006 Saint Louis University Medical School St. Louis, MO Southeast National SUIDI Training Academy September 18-21, 2006Atlanta, GA Northeast National SUIDI Training Academy March 2007 Baltimore, MA Southwest National SUIDI Training Academy Summer 2007 Albuquerque, NM

16、Northwest SUIDI Training Academy Spring 2008 Seattle , Washington, 2008,SUIDI Academy Students,Medical Examiner/Coroner Forensic Pathologist Jurisdiction population 400,000 Post-Secondary Teaching Professor Criminal Justice Forensic Science Allied Health Sciences Law Enforcement Officer Investigates

17、 Deaths Certified Post Training Officer Medicolegal Investigator EMS/Fire/Nurse/PA/etc. Child Protection Expert Child Death Review Team Member Social Services,Future CDC Activities,Explore state-based system for monitoring SUID Conduct additional train-the- trainer academies Collaborate with other c

18、ountries training materials and investigation protocols,SUID Initiative Team,Terry Davis, EdD ddu8cdc.gov Kay Tomashek, MD, MPH kct9cdc.gov Carrie Shapiro-Mendoza, PhD, MPH ayn9cdc.gov Sarah Blanding, RD dli2cdc.govCenters for Disease Control and Prevention 4770 Buford Highway, NE, Mailstop K-23 Atlanta, Georgia 30341-3717 770-488-6250http:/www.cdc.gov/SIDS.htm,