Gekkan Silver Age [Silver Age Monthly], May 1997

"Emergency Medical Treatment: Crisis Management at Home"

by Mitsuhiro Minato, Lifesaving Workshop Q+Q Yume Koubou   (Emergency Medical Treatment Specialist No. 00165; former leader of an emergency medical treatment team, Fire Defense Agency, Tokyo Metropolitan Government   Phone: 099-265-7189. Headquarters: 34-22 Hoshigamine 2-chome, Kagoshima City 891-01.

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Emergency Medical Treatment: Crisis Management at Home (8)
by Mitsuhiro Minato, Lifesaving Workshop Q+Q Yume Koubou

Phone: 099-265-7189

Sudden Infant Death Syndrome Strikes Some 600 Babies a Year

The death of a baby comes suddenly without any warning signs, and neither the parents or other caregivers can predict its occurrence. Sudden infant death syndrome (SIDS) is traumatic for parents, family and friends.

(1) Description of a Medical Emergency

A 6-month-old infant stopped breathing while sleeping and turned cold in a nursery room in a hotel.

(2) Synopsis of Activities of Silver Age Emergency Ambulance Team

Sounding the two-tone horns, the ambulance was on its way to the site. The message from the Control Center read: "The 119 operator gave first-aid instructions to the nursery caretaker who placed the call. Artificial respiration and external chest compressions are being applied."

Judging it was a case requiring life-support measures, I, the ambulance team leader, requested that the nearest H Emergency Medical Center be informed, and directed the team members to check the life-support material and equipment including the infant respirator mask and equipment for passive rewarming.

When communication works as it should, the following steps can be assured:

A. The informant receives first-aid instructions.

B. Receiving medical facilities are notified.

C. Emergency medical treatment material and equipment on the ambulance are checked.

The ambulance arrived at the site six minutes after the 119 call was made. The hotel security guard described the situation to me as follows:

A. Without waiting for the arrival of the ambulance, a hotel employee and the nursery caregiver took the infant to the nearby Hospital A.

B. The nursery caregiver administered mouth-to-mouth resuscitation and two-finger chest compressions on the pallid body of the infant.

C. The baby nursery in the hotel is provided as a service to hotel guests. The Child Room kept the infant for the duration of a lecture meeting. The victim is a 6-month old boy.

The victim required an emergency treatment at Emergency Medical Center H. The duty doctor at Hospital A on that day being a nose, ear, and throat specialist, I surmised that adequate treatment could not be given there. Judging that the ambulance could get quickly to Hospital A, which was located 300 meters from the hotel, we rushed to the hospital, arriving there 10 minutes after the 119 call.

The nurses who usually stand by at the Emergency Room entrance were unusually quiet. A doctor and a nurse were performing CPR on the infant. On the floor, the nursery caregiver and the hotel employee were crying and screaming, putting their hands flat together, "Please help him! Please do something!"

The doctor told me, "We have done what we could. I was just about to request an ambulance for transferring the patient."

We began transferring the infant to Emergency Medical Center H. The nursery caregiver and the hotel employee were visibly shaken by the sudden turn of events. Taken into due consideration their desire to do something to save the infant, and to touch his body, I told them to apply a massage on the lower half of the infant's body.

Frantic attempts were made to resuscitate the victim in the speeding ambulance.

The ambulance arrived at the Emergency Medical Center, and the victim was handed over to an emergency medical team. The ECR monitor confirmed the return of spontaneous circulation.

The condition of the patient was diagnosed as very serious, meaning that the life was at a serious risk of expiring. The cause was unknown.

The nursery attendant and the hotel employee squatted down on the floor, still visibly perturbed and blaming themselves for the mishap. I invited them to sit on a sofa in the waiting room.

I [later informed] the manager of the hotel and the person in charge of the nursery room as follows:

A. The incident was traumatic to the nursery room attendant and the hotel employee, and they continue to blame themselves for its occurrence. Please give them understanding and support, and provide them with continuing counseling.

B. As soon as the nursery attendant discovered that something was wrong with the baby, she made a 119 call giving all the right information, and administered artificial respiration and chest compressions following the instructions given over the phone.

C. The hotel employee who was informed of the situation tried to resuscitate the infant in cooperation with the nursery caregiver.

D. In the ambulance, they both gave a massage on the lower half of the baby's body.

As a result, the baby's heartbeats had resumed by the time his parents arrived at the hospital

One aspect of the whole process which could have been handled better was the fact that the victim was moved from the hotel, from where the 119 call was made, to Hospital A, delaying the arrival of the ambulance.

(3) A Sequel to the Event

Despite all the medical attention given, the infant later died, and the cause of death was identified as SIDS (sudden infant death syndrome). This is a medical disorder that causes a sudden death of an otherwise healthy infant. When a sudden death which occurs to an infant cannot be explained from the health of the child when the death occurs and a review of the clinical history of the victim, the death is diagnosed as SIDS. In Japan, about 600 infants die of SIDS each year.

SIDS Family Association Japan is organized by a group of volunteers who provide grief-stricken parents with comfort and understanding support. For information, call Mother's and Children's Welfare Association, Phone: 03-3499- 3111. Elsewhere, information on the prevention of SIDS is made available to childcare providers by Mommy Home Childcare Service (Phone: 082-878-9219).

(4) Be Prepared for SIDS

Get training in emergency medical treatment at the occasion of a gathering celebrating the birth of a child!


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