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Chapter 11 SIDS - Summary Forensic Pathology, Second Edition

notes on chapter 11 discussing SIDS and how a death is identified as S...
Course

 Forensic Pathology (FSC 451 )

15 Documents
Students shared 15 documents in this course
Academic year: 2017/2018
Listed bookForensic Pathology
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Gabrielle LaRocca
Syracuse University
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Warning: TT: undefined function: 32 Key words Etiology ○ The causes or manner of causation of a disease

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Characterized by the sudden, unexpected death of an apparently healthy infant who is left than one year of age

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Only determined as the cause of death when an examination of the scene of death is done, a review of the clinical history is done, and a complete postmortem examination all fail to reveal a cause of death

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Caused by a heterogeneous group of disease processes and is not due to a single entity

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  • A diagnosis of exclusion Has been ascribed to: ○ Status thymolymphaticus ○ Interstitial pneumonitis Suffocation § Manifested by an enlarged thymus Suffocation as an explanation of sudden death in infancy could not be substantiated

§

○

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Incidence of SIDS ○ Has been dropping steadily Due to the academy of pediatrics task force on infant positioning and SIDS announcing that infants should be placed on their sides and backs to sleep

○

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Presentation of cases ○ Most cases occur between 2 and 4 months of age Premature infants are at a greater risk for SIDS, but most cases involve full-term infants

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○ SIDS deaths almost always occur when the child is asleep

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Non-hereditary nature of SIDS No evidence of a genetic etiology § Siblings of SIDS victims have the same risk as the general population

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After the first SIDS death, the mother is labeled undetermined and a more intensive investigation of the circumstances surrounding the death is

○

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Chapter 11: SIDS

Sunday, June 11, 2017 1:32 PM

intensive investigation of the circumstances surrounding the death is conducted A third death by the same mother is homicide until proven otherwise

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When autopsying, it is good to save samples of skin, liver, muscle, kidney, lung, brain, and heart

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Diagnosis of SIDS Diagnosis cannot be made without a complete autopsy, no physician should sign a death certificate as SIDS without an autopsy If the family is able to prevent an autopsy, label the death "undetermined"

§

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Autopsy should include a full examination with microscopy and toxicology § Electrolyte examination may reveal dehydration

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Etiology of SIDS Presumably multifocal and includes not only natural causes but accidents and rarely homicide

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Theories have included § QT interval § Immunopathogenesis § Unstable homeostatic control § Caused by DPT vaccine § Hereditary idiopathic apnea

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Investigation of the death Three components to the investigation (just like any): The scene investigation □ Document the scene, body position, etc. □ Question the circumstances surrounding the death

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§ The autopsy § The laboratory studies

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The following information should be obtained § Age, date of birth, birth weight if known, race, and sex § Who was the last person to see the infant alive (date and time)? § Who discovered the dead infant (date and time)? What was the place of death (the child’s crib or bed, the parent’s bed, or elsewhere)?

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§ What was the position of the infant when found dead? § Was the infant’s original position changed (why and by whom)? If resuscitation was attempted, give the method and the name of the person who attempted the resuscitation.

§

○

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Chapter 11 SIDS - Summary Forensic Pathology, Second Edition

Course:  Forensic Pathology (FSC 451 )

15 Documents
Students shared 15 documents in this course

University: Syracuse University

Was this document helpful?
Key words
Etiology
The causes or manner of causation of a disease
○
-
Characterized by the sudden, unexpected death of an apparently healthy infant
who is left than one year of age
-
Only determined as the cause of death when an examination of the scene of
death is done, a review of the clinical history is done, and a complete
postmortem examination all fail to reveal a cause of death
-
Caused by a heterogeneous group of disease processes and is not due to a
single entity
-
A diagnosis of exclusion
-
Has been ascribed to:
Status thymolymphaticus
○
Interstitial pneumonitis
○
Suffocation
Manifested by an enlarged thymus
§
Suffocation as an explanation of sudden death in infancy could not
be substantiated
§
○
-
Incidence of SIDS
Has been dropping steadily
○
Due to the academy of pediatrics task force on infant positioning and SIDS
announcing that infants should be placed on their sides and backs to sleep
○
-
Presentation of cases
Most cases occur between 2 and 4 months of age
○
Premature infants are at a greater risk for SIDS, but most cases involve
full-term infants
○
SIDS deaths almost always occur when the child is asleep
○
-
Non-hereditary nature of SIDS
No evidence of a genetic etiology
Siblings of SIDS victims have the same risk as the general population
§
○
After the first SIDS death, the mother is labeled undetermined and a more
intensive investigation of the circumstances surrounding the death is
○
-
Chapter 11: SIDS
Sunday, June 11, 2017

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