SUIDI & DOSE Training

Kelly Cunningham, MPHFatality SpecialistFriday, November 18, 2016

Goals of Consistent SUIDI

Sudden Unexplained Infant Death Investigation

• Standardize and improve data collected at the

death scene

• Promote consistent diagnosis of cause of death

• Enhance communication between team members

• Learn from collective knowledge to prevent

future infant deaths

Forensic Autopsies Start at the Scene

Past Medical& Surgical History

Medications &

Therapies

Recent Complaints & Review of Systems

Psycho-Social History

Gross Examination(External & Internal)

MicroscopicExamination

LaboratoryExamination

RadiographicExamination

Hospital Course & Outcome

Resuscitative Efforts& Artifacts

Scene InvestigationEvidence, Diagrams & Photographs

Circumstantial /Witness Accounts

COD & MOD

Components of a Consistent SUIDI

• Scene investigation

• Doll reenactment– Interviews

– Victim data

• Pre-autopsy report

May eventually lead to a Certification of SIDS…

SUIDI Team Players Death Investigators

Law enforcement Child Protection Investigators Coroners / Deputy Coroners

Prosecutors Pathologists

Family and witnesses

Placer Last Known Alive Finder

Doll reenactment• A death scene investigation needs to be

performed on ALL infant deaths

• A re-enactment is an essential part of a thorough death scene investigation (N.A.M.E, CDC,

NIJ, ABMDI, International Assoc. of Sheriffs & Police Chiefs, FBI, CDR)

• The autopsy begins at the scene

Finder

Placer

Pathologists’ Information

• Pre-Autopsy Report

• Can be generated electronically

• Feedback loop for post-autopsy conclusions

• SUIDI-EV: readable reports can be printed right from database

– Contains primary form + 10 add’l forms– http://www.cdc.gov/sids/pdf/suidirf-evhowto-508.pdf

Pre-Autopsy conference

• The autopsy is a process of the scene investigation.

• Allows for an overall review of the case information from the different disciplines involved for the benefit of the Pathologist and Prosecutor.

• Provides a tactical review for task assignment / readjustment.

Direct On-Scene Education

• DOSE is an innovative attempt at eliminating sleep-related infant death due to suffocation, strangulation or positional asphyxia by using First Responders to identify and remove hazards while delivering education on scene

• First Responders are trained to identify and remove hazards from an infant's sleep space while on scene during emergency and non-emergency 911 calls

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DOSE

• How First Responders can proactively reduce infant sleep-related death

• Created by a firefighter and NICU nurse in Broward County, Florida

• All operations personnel are trained in the most current SUID/SIDS education per the AAP (American Academy of Pediatrics)

• DOSE works in conjunction with a Safe Sleep Crib Distribution Program

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DOSE - Training

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• Always place baby on back for every sleep time.

• Use a firm sleep surface covered with fitted sheet.

• Room sharing without bed sharing.

• Keep soft objects and loose bedding out of baby’s sleep area.

• Pregnant women should receive regular prenatal care.

2016 AAP Recommendations

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Promote a Safe Infant Sleep

Environment

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Contact Information

Kelly Cunningham, MPHChild Fatality SpecialistState of Indiana DOSE Administrator317.652.4643kcunningham2@isdh.in.gov

Gretchen Martin, MSWDirectorFetal, Infant and Child Fatality Review and Safe Sleep Programs317.233.1240gmartin1@isdh.in.gov

Fausta Houzanme, MPHSafe Sleep Coordinator317.233.7258fhouzanme@isdh.in.gov

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