The management of a nonresuscitatable SIDS infant and his or her family is equally challenging for a physician. The emergency department physician is confronted by the distraught mother who had fed her infant several hours earlier, went to check the sleeping infant, and found the baby cold, blue, and lifeless. Frequently, valiant though unsuccessful efforts are carried out in the emergency department, or the infant is revived briefly, only to succumb after several hours in the intensive care unit.
The major responsibility of the physician is then to notify, counsel, and educate the family. In most jurisdictions, victims of sudden and unexplained deaths must be referred to the coroner's office, where an autopsy is performed at the coroner's discretion.35 Some jurisdictions have infant death teams that fully evaluate the circumstances surrounding the unexpected death of young infants. If the physician believes the infant is a victim of SIDS, the family should be so advised but told that the final confirmation awaits the autopsy report. The emergency physician should assure the family about their lack of responsibility for the infant's death and assuage their feelings of guilt. He or she should then serve as a facilitator maintaining contact with the family to advise them of the autopsy results. The hospital chaplain or social worker may provide additional support, but the physician's empathy is especially supportive to the family. Most communities have organizations for parents of SIDS victims, and information about these organizations can be obtained from the National Foundation for Sudden Infant Death, 101 Broadway, New York, New York 10036. Parents should be referred to these organizations. Additional information can be obtained from the National Sudden Infant Death Syndrome Resource Center, 8201 Greensboro Drive, Suite 600, McLean, Virginia 22102, telephone (703) 821-8955.
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