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Responding to unexpected infant deaths : experience in one English region

By Peter Sidebotham, Peter S. Blair, Carol Evason-Coombe, Margaret Edmond, Ellen M. A. Heckstall-Smith and Peter J. Fleming


New national procedures for responding to the unexpected death of a child in England\ud require a joint agency approach to investigate each death and support the bereaved\ud family. As part of a wider population-based study of sudden unexpected deaths in\ud infancy (SUDI) we evaluated the implementation of this approach.\ud Methods: A process evaluation using a population-based study of all unexpected\ud deaths from birth to 2 years in the South West of England between January 2003 and\ud December 2006. Local police and health professionals followed a standardised\ud approach to the investigation of each death, supported by the research team set up to\ud facilitate this joint approach as well as collect data for a wider research project.\ud Results: We were notified of 155/157 SUDI, with a median time to notification of 2\ud hours. Initial multi-agency discussions took place in 93.5% of cases. A joint home\ud visit by police officers with health professionals was carried out in 117 cases, 75%\ud within 24 hours of the death. Time to notification and interview reduced during the 4\ud years of the study. Autopsies were conducted on all cases, the median time to autopsy\ud being 3 days. At the conclusion of the investigation, a local multi-agency case\ud discussion was held in 88% of cases. The median time for the whole process\ud (including family support) was 5 months.\ud Conclusions: This study has demonstrated that with appropriate protocols and\ud support, the joint agency approach to the investigation of unexpected infant deaths\ud can be successfully implemented

Topics: HQ, RJ
Publisher: BMJ Group
Year: 2010
OAI identifier:

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