Sudden infant death syndrome: Difference between revisions
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===Risk Factors=== | ===Risk Factors=== | ||
*Prone sleeping | *Prone sleeping | ||
**Odds ratio of 4.92, one of biggest modifiable risk factors | |||
**Likely from combination of hypercarbia and hyperthermia (heat dissipated through head) | |||
*Soft bedding | *Soft bedding | ||
*Bed-sharing | *Bed-sharing | ||
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*Prematurity / Developmental delay | *Prematurity / Developmental delay | ||
*Socioeconomic disadvantage | *Socioeconomic disadvantage | ||
*Mothers <20 yo | |||
*Maternal exposure to smoking, alcohol, drugs of abuse | *Maternal exposure to smoking, alcohol, drugs of abuse | ||
===Protective Factors=== | |||
*Use of pacifier | |||
*Breastfeeding | |||
*Immunizations | |||
*Home monitoring is NOT protective | |||
==Clinical Features== | ==Clinical Features== | ||
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==Management== | ==Management== | ||
*Infants with rigor mortis, livedo reticulrais, pH <6, or reduced temperature in absence of environmental hypothermia should not be resuscitated | *Infants with rigor mortis, livedo reticulrais, pH <6, or reduced temperature in absence of environmental hypothermia should not be resuscitated | ||
*Examine for signs of NAT | |||
**Bruising, petechiae (especially to face on conjunctivae), torn frenulum, blood in mouth or nares | |||
*Do not manipulate body- all cases require evaluation by coroner/ME | |||
*SIDS is a post-mortem diagnosis; ED chart should read "sudden unexpected death in infancy" | |||
==See Also== | ==See Also== | ||
Revision as of 15:46, 20 June 2019
Background
- Abbreviation: SIDS
- Unexpected death of infants <1yr for which no pathologic cause can be determined
- Most deaths occur between 2-4 months of age
- Rare in <1 month of age
- Diagnosis of exclusion
Risk Factors
- Prone sleeping
- Odds ratio of 4.92, one of biggest modifiable risk factors
- Likely from combination of hypercarbia and hyperthermia (heat dissipated through head)
- Soft bedding
- Bed-sharing
- Parental smoking
- URI
- Male sex
- Prematurity / Developmental delay
- Socioeconomic disadvantage
- Mothers <20 yo
- Maternal exposure to smoking, alcohol, drugs of abuse
Protective Factors
- Use of pacifier
- Breastfeeding
- Immunizations
- Home monitoring is NOT protective
Clinical Features
Differential Diagnosis
Evaluation
Management
- Infants with rigor mortis, livedo reticulrais, pH <6, or reduced temperature in absence of environmental hypothermia should not be resuscitated
- Examine for signs of NAT
- Bruising, petechiae (especially to face on conjunctivae), torn frenulum, blood in mouth or nares
- Do not manipulate body- all cases require evaluation by coroner/ME
- SIDS is a post-mortem diagnosis; ED chart should read "sudden unexpected death in infancy"
See Also
References
- The Sudden Infant Death Syndrome. N Engl J Med 2009; 361:795-805