Sudden Infant Death Syndrome, Apparent Life-threatening Events
Pathophysiology
There are a lot of controversies surrounding SIDS pathophysiology. Three dominant post-mortem findings include the following: heart with unclotted blood, intrathoraic petechiae, and heavier organs filled with fluids. However, these findings are not concrete enough to provide a clear understanding of SIDS final pathology (Byard & Byard, 2010). The currently shunned theory, the ‘apnea theory’ which was proposed in the year 1970, helped in bringing about years and years of research and the emergence of apnea nursing industry. Nonetheless, in the index scenario which first impelled investigation of the association between SIDS and apnea, the new born was killed by the mother after confession (Acton, 2012). Current research however states that, SIDS is the concluding common path of three corresponding factors. A child must have a primary and then be stressed by an exogenous source. Finally, SIDS can only occur in a period of a life-threatening growth period (Marx, 2010).
Epidemiology
2 out of 1000 live births is likely to be to be affected by SIDS. In some new-born categories occurrences of SIDS may be more than in the total population (Acton, 2012). These sorts concern sibling and the twin of SIDS victims, untimely infants, and intra-uterine infants with drug exposure. Male infant as compared to female infants, are at high risk of exposure. In addition, a genealogically temperament has also been suggested: both black and Indian infants are prone to exposure, whereas other Asian infants are at a reduced risk (Byard & Byard, 2010).
Physical Exam Findings
At the scene of death, a closer look should be taken thus examining for the signs of impediment of the external airways, unintentional frame-up of the head, or other environmental factors which may have led to the death (Acton, 2012). After a transitory resolute unexplained events, most patients extant the emergency department in no acute distress. Out of 50% of the infants, the physical examination is usually normal. Out of the total number of patients in the emergency department, 25% of them tend to be documented with pyrexia (Marx, 2010). However, BRUE and ED might not be very effective ion providing the real cause of the death of an infant, hence more examination should also be conducted to ensure clear observations and inferences are made (Byard & Byard, 2010).
Differential Diagnoses and Rationale
Different causes of death which may include infection, innate faults of metabolism, electrolyte abnormalities, and child abuse, need be removed before the death can be linked to SIDS (Acton, 2012). A POSSIBLE SIDS should be examined through the inclusion of a full scene of death assessment and a full post-mortem should also be done, followed by radiographic emaciated investigation (Byard & Byard, 2010). Death scene needs to include the temperature, the position in which the baby was lying, and any form of rigor mortis.
Management Plan
There is no diagnostic test for SIDS currently, however, SIDS diagnosis is reached particularly when the actual cause of death is not known after a death scene examination, or a post-mortem and an evaluation of clinical history (Byard & Byard, 2010). There is no actual medication for SSID, since the condition is only diagnosed after the death of an infant. However, it is advised to put children to sleep on their backs as opposed to sleeping on their bellies’, not sleeping in the same bed as the baby, but in the same room with separate beds, put babies to sleep on slightly rough bedding materials, and avoid smoking while pregnant (Acton, 2012).
References
Byard, R. W., & Byard, R. W. (2010). Sudden death in the young. Cambridge: Cambridge University Press.
Acton, Q. A. (2012). Sudden Infant Death Syndrome (SIDS): New insights for the healthcare professional : ScholarlyPaper.
Marx, J. A., Hockberger, R. S., Walls, R. M., Adams, J., & Rosen, P. (2010). Rosen's emergency medicine: Concepts and clinical practice. Philadelphia: Mosby/Elsevier.
