DOSE : Direct On Scene Education ™: “Baby Safe Sleep Initiative” Prepared by: Captain James Carroll And Jennifer Combs, MSN, ARNP Healthy Mothers, Healthy Babies Coalition of Broward, Inc.
Objectives: • Learners will be able to understand the problem of sleep related infant death. • Learners will be able to list 5 components of a safe sleep environment for an infant. • Learners will be able to describe the DOSE: Direct On Scene Education ™ program.
“ Oh Baby, We Have a Problem!”
Just the Facts…. • Each year in the United States, there are about 3,600 Sudden Unexpected Infant Deaths (SUID). infants less than 1 year old and have no immediate obvious cause. • The three commonly reported types of SUID are: • •SIDS: About 1,500 infants died of SIDS in 2016. • •Unknown cause: 1,200 infants • •Accidental suffocation and strangulation in bed: 900 infants
SIDS vs. Accidental Sleep Related Deaths What’s the difference?
SUID • SUID: Sudden Unexpected Infant Death • SUID is the umbrella heading under which sudden infant deaths are classified • SUID includes accidental sleep related deaths • Reducing Risk versus Prevention • Must know the difference between SIDS and ASSB (accidental suffocation, strangulation in bed) • Important to know the difference between the two when educating the community
SUID Unexplained Explained SIDS Known Undetermined Diagnosis Accidental Positional Suffocation & Asphyxia Strangulation in bed Trauma Poisoning Drowning
What is SIDS? Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant younger than 1 year of age that remains unexplained after a thorough case investigation, including: – Performance of a complete autopsy – Examination of the death scene – Review of the infant’s and family’s clinical histories
SIDS is NOT … • Not Preventable , but the risk can be reduced! • Not caused by vomiting and/or choking • Not caused by DPT vaccine or other immunizations • Not contagious • Not the result of child abuse or neglect • Not the cause of every unexpected infant death
Maternal Risk Factors • Smoking during and after pregnancy • Age less than 18 years • Poor or limited prenatal care • Anemia • Drug or Alcohol use (paternal use also) • Poor baby spacing <18 months • History of STDS/Urinary tract infections
Infant Risk Factors • Low Birth weight <2,500 grams • Prematurity <37 weeks • Black • Native American • Exposure to tobacco smoke and drugs • Males • Multiple gestation
Disparities • Disparities exist • Native American • African American • Why?
Native Americans
African Americans
SUID Risks Summary • Stomach sleeping • Soft sleep surfaces, pillows, toys and loose bedding • Overheating during sleep • Maternal smoking during pregnancy and second hand smoke in the baby’s environment • Bed sharing with an adult or with other children
Sleep Related Deaths • Are 100% preventable!!! • Accidental Suffocation and Strangulation in Bed (ASSB) • Falls under SUID • Types: – Suffocation – Wedging – Entrapment – Strangulation
Bumper Pads • Should be removed from crib • Suffocation hazard • Babies burrow into corners • Banned from being sold in Chicago and in the state of Maryland
Suffocation from Bed Sharing
Crib Wedging
Bed Wedging
Wedging
Entrapment
Positional Asphyxia
Positional Asphyxia
Dangerous Places to Sleep
Pillows
Twins
Risk Reduction/Safe Sleep Recommendations 1. Baby should sleep on the back for each and every sleep. 2. Baby should sleep alone in their own separate sleep space: crib, bassinet, pack-n-play. 3. No bed sharing with adults or other children. 4. Firm mattress with tight fitting crib sheet only. 5. No toys, pillows, loose bedding in the crib.
Risk Reduction/Safe Sleep Recommendations 6. No bumper pads! 7. No exposure to tobacco smoke. 8. Offer a pacifier each and every sleep. 9. Room sharing with caregiver. 10. Do not allow baby to overheat with sleep: one layer of clothing; if cooler weather, then no more than one extra layer of clothing than the adult is wearing.
How to Keep Baby Safe to Sleep: ABCs of Safe to Sleep
DOSE Direct On Scene Education™ Introduction What is it? How does it work? Why does it work?
In the Beginning… . How did this come to be?
Healthy Mothers, Healthy Babies Coalition of Broward • The Fetal Infant Mortality Review is conducted each year by HMHB of Broward in Broward County, Florida • Excess amount of sleep related infant deaths • Community engagement projects including working with first responders to address the issue
City of Fort Lauderdale Population in 2016: 178,752 2.6 million visitors per year 34.77 square miles, 4,761 per square mile FD-12 Stations, 450 FF 60K calls a year
Safe Sleep Summit 2011
What can we do???
First Responders to the Rescue! • Captain Carroll attended the “Safe Sleep Summit” and was shocked by the number of deaths • “Baby Safe Sleep Initiative” was developed together by Captain Carroll and Jennifer Combs, MSN, ARNP in collaboration with Healthy Mothers, Healthy Babies Coalition of Broward • DOSE: Direct On Scene Education™
“Baby Safe Sleep Initiative”
Broward • 41% of the sleep related deaths, seven total, occurred in the city of Fort Lauderdale in 2011 • Fort Lauderdale Fire Rescue operates 11 stations throughout the city and runs over 42,000 emergency calls a year. • There was a lack of awareness about the magnitude of the number of sleep related infant deaths occurring not only in the city, but throughout the county
How It Works
Why It Works • First responders fix things by nature • First responders are easily recognizable • Trusted by the community • Unique access to the homes • Informal education being done already
Components • Evaluation of community problem • Partnering with community maternal child health agencies • Education of first responders • Sleep environment check • Removal of hazards, crib referral or set up • Family education • Referral to community partners
Success Stories!
When they technically have a crib…
4 8
4 9
Watch It Work
What We Have Accomplished * FLFR Baby Sleep Deaths 2011: 7 *FLFR Baby Sleep Deaths 2012: 3 *FLFR Baby Sleep Deaths 2013: 3 *FLFR Baby Sleep Deaths 2014: 1 *FLFR Baby Sleep Deaths 2015: 2 *FLFR Baby Sleep Deaths 2016: 3
I was lucky, let’s be smart…
Questions? More Information? Captain James Carroll Fort Lauderdale Fire Rescue JCarroll.DOSE@gmail.com Jennifer Combs, MSN, ARNP nicurn13@att.net
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