Death of a Child

Question 1

You arrive at the scene of an expected death of a child, what should you look for?

Answer 1

A care plan

Question 2

You arrive at the scene of an expected death of a child, you find a care plan, what are your next steps?

Answer 2

Recognise life extinct

Contact names clinician; leave child at home

Question 3

You arrive at the scene of an expected death of a child, there is no care plan available, what is your next step?

Answer 3

Transport child and parents to ED; inform ambulance control to direct police to hospital

Question 4

You arrive at the scene of an unexpected child death, what should you first determine?

Answer 4

Query if a crime scene is present

Question 5

You arrive at the scene of an unexpected child death, there is a questionable crime scene, what is your next step?

Answer 5

Determine if resuscitation is viable

Question 6

You arrive at the scene of an unexpected child death, there is a questionable crime scene, resuscitation is viable, what are your next steps?

Answer 6

Commence resuscitation

Transport child and parents to ED; inform ambulance control to direct police to hospital

Question 7

You arrive at the scene of an unexpected child death, there is a questionable crime scene, resuscitation is not viable, what are your next steps?

Answer 7

Determine if there is an obvious cause of death

Question 8

You arrive at the scene of an unexpected child death, there is a questionable crime scene, resuscitation is not viable and there is no obvious cause of death, what is your next step?

Answer 8

Transport child and parents to ED; inform ambulance control to direct police to hospital

Question 9

You arrive at the scene of an unexpected child death, there is a questionable crime scene, resuscitation is not viable and there is an obvious cause of death, what are your next steps?

Answer 9

Ask ambulance control to contact police and await attendance or telephone advice of a child death DI and follow instructions

Question 10

After speaking to a child death DI you could be given one of two courses of action, what could these be?

Answer 10

Advised to take child and parents to ED and pre-alert and take to appropriate ED that is prepared to accept sudden deaths in children
Crime scene declared; leave child at scene; inform ambulance control

Question 11

You arrive at the scene of an unexpected child death, there is an obvious crime scene, what is your next step?

Answer 11

Determine if the child has a condition unequivocally associated with death
Resuscitation should not be attempted if they do

Question 12

What are the seven conditions unequivocally associated with death?

Answer 12

Hypostasis/Lividity
Rigor Mortis
Decapitation
Massive cranial and cerebral destruction
Incineration
Traumatic Hemicorporectomy
Decomposition/Putrefaction

Question 13

What is Hypostasis/Lividity?

Answer 13

the accumulation of fluid or blood in the lower parts of the body or organs under the influence of gravity, as occurs in cases of poor circulation or after death.

Question 14

What is hypostasis often referred to as?

Answer 14

Mottling

Due to the skin having a mottled appearance

Question 15

Why is hypostasis a diagnosis of death?

Answer 15

the appearance is never present in a live subject

Question 16

Common identification signs of hypostasis?

Answer 16

Initially seen as small round patches mimicking bruises

Above the hypostatic engorgement (pooling of the blood) there is obvious pallor of the skin

Question 17

What is Rigor Mortis?

Answer 17

The stiffening of the body after death

Once the contracting of all the body’s muscles has taken place this state of rigor - technically referred to as the Rigid Stage - normally lasts anything from eight to twelve hours after which time the body is completely stiff; this fixed state lasts for up to another eighteen hours..

Question 18

How long does Rigor Mortis normally occur after death?

Answer 18

normally appears within the body around two hours after the deceased has died

Question 19

What are the stages of Rigor Mortis?

Answer 19

Once the contracting of all the body’s muscles has taken place this state of rigor - technically referred to as the Rigid Stage - normally lasts anything from eight to twelve hours after which time the body is completely stiff; this fixed state lasts for up to another eighteen hours

Question 20

Signs of Rigor Mortis?

Answer 20

The limbs and joints of the deceased are stiff (rigid) and difficult to move or manipulate, this usually affects the smaller muscles first, such as those in the face, neck, arms and shoulders making the insertion of an intubation tube difficult or impossible

The body holds its position when moved

Question 21

Why is massive cranial and cerebral destruction unequivocally associated with death?

Answer 21

Where injuries to skull and brain are considered by attending healthcare professional to be incompatible with life, such as catastrophic head injury

Question 22

What is meant when the term incineration is used in conditions unequivocally associated with death?

Answer 22

The presence of full thickness burns with charring of greater than 95% of the body surface

Question 23

What is meant by the term Traumatic Hemicorporectomy?

Answer 23

The body is completely cut across below the shoulders and above the hips through all major organs and vessels
The spinal column may or may not be severed

Question 24

What is meant by Decomposition/Putrefaction when looking at conditions unequivocally associated with death?

Answer 24

Where tissue damage indicates that the patient has been dead for some hours, days or longer.

Question 25

You arrive at the scene of an unexpected child death, there is an obvious crime scene and the child has a condition unequivocally associated with death, what are your next steps?

Answer 25

Ask ambulance control to contact police and await attendance or telephone advice of a child death DI and follow instructions
The child death DI will either declare a crime scene and you should leave the child at the scene or you will be advised to take both the chid and the parents to the nearest ED

Question 26

You arrive at the scene of an unexpected child death, there is an obvious crime scene and the child does not have a condition unequivocally associated with death, what are your next steps?

Answer 26

Commence resuscitation
Ask ambulance control to contact the police
Pre-alert and take to appropriate ED that is prepared to accept sudden deaths in children