Pitfalls
- Remember not to remove the endotracheal (ET) tube until the position has been checked by a second clinician who is competent to intubate.
- Document all attempts at cannulation and intraosseous (IO) access, including the unsuccessful ones.
- Once the child has been confirmed to be dead, do not send any investigations via the pod system. They must be walked to the lab to be handed over in person, and the chain of evidence form completed.
- The attending police may be unsure of the rules around the parents access to the child once they have been confirmed as dead. Try to avoid any conflict as they will be doing so from the viewpoint that the death is a potential crime until proven otherwise, but encourage them to discuss with their seniors.
- Remember to keep the nappy and any clothes that the child was wearing on arrival, as they may contain vital evidence.
- The parents/carers will remember what they see and what is said forever. The resuscitation must be seen to be professional and thorough, and communication during and afterwards is vital. Make sure that you are fully prepared before you speak to them. The assigned nurse needs to be senior and experienced enough to manage this important role appropriately.
- Try and assign a nurse to the parents who is not near the end of their shift, wherever possible. This means that they can continue to care for the parents throughout the whole process. Be mindful of how stressful this is for the nurse in question.
- All members of the multi-disciplinary team are likely to be traumatised. A hot and cold debrief are often beneficial and should be considered as part of the protocol.