THE ED PLYMOUTH
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When a child dies in the ED

This is one of the most stressful events an emergency worker may face. The department endeavor to run a debrief soon after any unexpected child death within ED. If you have been involved in the case you will be invited & encouraged to attend this. You should also feel able to discuss the case with either the consultant involved or your clinical supervisors.
 
All deaths of babies & children under the age of 18 in England are investigated according to a set process. It is vital that all child deaths are carefully reviewed so that we may learn as much as possible from them to try to prevent future deaths & support to families.
 
Within ED there is a file that contains all the paperwork required for the review process. The medical team need to complete the review process (unless the child is under the care of a paediatrician for a chronic condition that is likely to be related to the death). Checklist:
 
  1. If not already involved the police MUST be informed of the death
  2. Social care must be contacted for background information about the family & any siblings.
  3. The child must be examined:
    1. If suspected homicide the police must be involved
    2. If possible suicide remember to look for bruising, self-harm, goitre, rashes
    3. If an RTC an orthopaedic surgeon may be asked for an opinion
  4. ALWAYS discuss investigations with the coroner; they can be contacted out of hours.
  5. Toxicology should be considered, there is an agreed set of tests for this but you might want to add to that, for example anti-epileptic drug levels.
  6. Take samples for blood cultures and consider viral screen or TFTs.
  7. Speak to the parents. A joint interview with the police is best practice. Try to get a full a history as possible& document on the sheets provided within the protocol.
  8. Inform the rapid response team. They will attend ED if possible during working hours & will visit the home within 48 hours to provide ongoing support for the family.
  9. A strategy discussion MUST take place between the ED doctor, police & social care to agree what the next action should be. This might well be very straightforward & may simply occur in a corner of rests if the case is an RTC.
 
A PM will be required & results of this should be fed back to the ED consultant on for the day. A local case discussion meeting will be held once the results of the PM are known. This is a multi-professional meeting with all of those involved in the child’s care up to & immediately after the death. Recommendations are made during this meeting & fed back to the Child Death Overview Panel as well as the coroner to help inform the inquest process. 
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  • Home
    • About us >
      • Accommodation in Plymouth
      • Contact us
    • TUEC >
      • Timeline
      • Current drawings
    • ED_Design
  • Academic
    • Who are we?
    • Live Studies
    • Why academic EM?
    • In the literature
    • Derribets
  • Education
    • Simulation
    • Derrifoam Blog >
      • Get involved
      • FOAM
    • Education Faculty >
      • Core Education guide
    • Induction >
      • MG doctor induction >
        • CT3 in Emergency Medicine
        • Clinical Fellow in EM & Medical Education
      • Junior doctor induction
    • Core education >
      • non-accs
      • accs
    • Higher specialist education
    • Nursing education
    • Practitioner education
  • Clinical
    • EM Induction
    • Guidelines