#PEST2015: SUDIC/NAI
““4-month-old unsettled over the afternoon then found unresponsive in cot. Mum out shopping, baby being looked after by her new partner.””
Observations
RR – 0
SpO2 – Unrecordable
HR – Asystole
BP – Unrecordable
Clinical findings
Bruising to face & limbs.
Respiratory distress.
Bulging fontanelle.
Why we simulated?
Severe injuries in infants are often caused by NAI (TARN, 2012). In these cases, evidence of trauma is not always immediately obvious so staff need to be alert to this possibility in shocked infants.
Learning outcomes
Remember to confirm cardiac arrest.
Consider parents/carers being present during resuscitation.
The decision to stop active resuscitation should involve the whole team as well as carers.
Importance of a “hot debrief”, don’t forget to include paramedics/pre-hospital staff.
Positive feedback
Thorough preparation prior to patient’s arrival.
Team remained calm & collected throughout. Room was quiet.
Use of closed loop communication between nurse & team leader when concerning features identified in history.
Good situational awareness of team leader.
