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SIDS FFrank Ferrucci,PA-C FAnna Jacques Hospital ED.

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Presentation on theme: "SIDS FFrank Ferrucci,PA-C FAnna Jacques Hospital ED."— Presentation transcript:

1 SIDS FFrank Ferrucci,PA-C FAnna Jacques Hospital ED

2 Definition FSudden death of an infant younger than 1 that remains unexplained after a thorough case investigation FOne of the most common causes of death between ages 1 mos and 1 year. FAccounts for roughly 25% of deaths in those under the age of 1.

3 Pathophysiology FExact cause is still unknown FCurrent though is of Triple risk Finfant with abnormalities in cardiorespiratory control Fcritical period of development Fexogenous stressor

4 Statistics FFrequency decreased significantly with public health campaigns such as “Back to Sleep.” F58% decrease since launch FHow infant sleeps determines risk FSIDS rate for US: 0.54/1000 births



7 Risk Factors FSleeping position FSmoking during prenatal period FBed sharing FBottle feeding FNon-pacifier use FBundling FBed coverings

8 Risk Factors FBlack/Native American ethnicities Findependent of youg maternal age, low birth weight, multi parous etc FMale>female FAge 2-4 mos F? link between infant development

9 HPI FTypically found apneic and pulseless FRecent meal and then put to bed FFull term, normal pregnancies FGenerally feed well and gain weight normally FParents generally report no symptoms prior to death F70% have minor URI

10 Exam FFrothy blood-tinged discharge @ nose or mouth FRigor mortis FLook for obstruction, entrapment of head, environmental causes etc FAutopsy generally unremarkable FNo signs of trauma should be present FPetechiae often found on thymus,pleura and epicardium

11 Causes FTriple risk model Fmultifactorial Fdeath due to un-deployable defenses FNeuropathology Fstructural and nerve cell abnormalities F? delayed development of brain stem Fcurrently being studied

12 Causes FCritical development period FSIDS most common 2-4 mos Fdramatic developmental change Fnear doubling of brain weight

13 Causes FExogenous Stressors Fchanges in oxygen/carbon dioxide in sleep environment Fchanges in ambient temperature Fpossible infectious component

14 Diagnosis FSudden Unexplained Death in Infancy Investigation and Reporting form FCDC/Dept of Health and Human Services

15 ALTE FDefinition FFrequency around 1-3% F25-50% of ALTE go unexplained FAssociation between ALTE and SIDS

16 Workup FDifferential is huge FData from scene, infant and family medical/social history and autopsy required to make diagnosis FNotify pediatrician

17 SIDS Episode FExpress condolences FHave family hold their child FInform family of autopsy FREASSURE family FRefer family

18 Prevention FSleep supine FPacifier use FBreastfeeding FAvoid bundling and head covering FKeep pillows, comforters etc out of crib FNo smoking FAvoid bed sharing


20 Resources FThe Association of SIDS and Infant Mortality Programs FNational SIDS/Infant Death Resource Center FAmerican Academy of Pediatrics FCDC F sudden_infant_death_syndrome_si ds/article_em.htm sudden_infant_death_syndrome_si ds/article_em.htm

21 Questions??

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