Management of sudden unexpected death in childhood (Rapid Response)
Last updated: January 9, 2009
Table of Contents
1i. Introduction
This procedure provides direction for professionals from agencies involved when a child [0-18 years] dies suddenly and unexpectedly.
Together with principles to follow and a definition, the procedure contains general advice and guidance for dealing with a sudden unexpected death and for inter-agency working. Each agency has its own specific guidelines that will complement this procedure: refer to the appendices.
All sudden unexpected deaths come within the remit of the coroner who has exclusive jurisdiction and control of the body of the deceased child. Individual circumstances are likely to require individual solutions and the coroner will always be willing to discuss specific arrangements between the hours of 07.00 and 23.00. Outside these hours the coroner should only be contacted in cases of absolute urgency.
Families should be treated with sensitivity, discretion and respect at all times, and professionals should approach their enquiries with an open mind.
1.ii Background
Children Act 2004 and Working Together 2006
One of the Local Safeguarding Children Board’s functions, set out in Regulation 6 of the Children Act 2004, in relation to the deaths of any children normally resident in their area is as follows:
“putting in place procedures for ensuring that there is a coordinated response by the Authority, their Board partners and other relevant persons to an unexpected death.”
Each unexpected death of a child is a tragedy for the family and subsequent enquiries/investigations should keep an appropriate balance between forensic and medical requirements and the family’s need for support.
Children with a known disability or a medical condition should be responded to in the same manner as other children.
A minority of unexpected deaths are the consequence of abuse or neglect, or are found to have abuse or neglect as an associated factor. In all cases, enquiries should seek to understand the reasons for the child’s death, address the possible needs of other children in the household, the needs of all family members, and also consider any lessons to be learnt about how best to safeguard and promote children’s welfare in the future.
A number of different agencies will become involved throughout the process of establishing the cause of the death.
This procedure is not intended to cover all aspects of sudden unexpected death but endeavours to provide direction to practitioners who are confronted with these tragic circumstances. In most cases the process will be lead by the paediatrician for sudden unexpected death in childhood unless there are suspicious circumstances, in which case the police will take over. It is acknowledged that each death has unique circumstances and each professional involved has their own experience and expertise which will be drawn upon in their handling of individual cases. Nevertheless, there are common aspects to the management of a sudden unexpected death that it is important to share in the interests of good practice and achieving a consistent approach for every child no matter what the circumstances.
This procedure gives an insight into the priorities for those professionals involved, in an attempt to promote a mutual understanding of each agency’s roles and responsibilities. Professionals need to strike a balance between the sensitivities of supporting the bereaved family, and securing and preserving anything that may aid in an understanding of why the child died.
When a child, whether a Greater Manchester resident or not, dies outside their usual area of residence, there should be discussion amongst the professionals involved as to which Authority’s procedure should be followed and which Authority should take the lead. In the event of disagreement the appropriate coroner will direct.
1.iii Aim
To ensure there is a coordinated multi-agency response for all sudden and unexpected child deaths by:
- close multi agency working, with sharing of information between clinical staff, pathologist, police, children’s social care, any other relevant agency, and coroner’s services.
- establishing, as far as possible, the cause of death
- preserving evidence at the place of death
- documenting fully all interventions by paramedical and medical staff, including resuscitation prior to the certification of death
- completing a full medical history and examination
- reviewing all medical records
- a pathologist [and if necessary a forensic pathologist] investigating the cause of death
- offering sensitive care and support to all affected by the death
- identifying and managing any risk to other siblings / children
- preserving all potential evidence in support of a potential prosecution or childcare proceedings.
