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Sudden, Unexplained Infant Death Initiative (SUIDI): How to
Use the SUIDI Reporting Form |
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SUIDI Reporting Form: A Guide for Investigators
The SUIDI Reporting Form is a guide for novice and veteran investigators
of infant deaths. The form is designed to ensure that all information is
collected in a consistent, sensitive manner. The form is designed as a
questionnaire. You can read the questions to the person you are
interviewing. Most questions can be answered by placing an "x" in the corresponding box or filling in the blank. The
eight-page form is divided into nine sections. For more information,
contact us.
- Investigation Data
This section is filled out first by the person (e.g., coroner, death scene
investigator, law enforcement official, medical examiner) who
interviews the witness.
- Primary residence. Address where the infant was living when he or
she died.
- Incident address. Address where the infant died or where the final
injury occurred.
- Witness. Person who knows some or all of the circumstances
surrounding the infant’s death. This may be the person who 1) last
placed the infant in or near the area where he or she was found not
breathing or breathing with distress, 2) last observed the infant alive,
or 3) found the infant not breathing or breathing with distress.
- Witness Interview
This section is filled out by the person who interviews the witness.
- Usual caregiver. The person who took care of the infant more than
50% of the time.
- Last placed. The last time the infant was put down to sleep or rest
(e.g., in a crib).
- Last known alive (LKA). The last time the infant was observed alive
(e.g., time when a parent heard the infant cry).
- Found. The act of finding the infant not breathing or breathing with
distress.
- Positional support. Item such as a wedge or pillow used to keep an
infant on their side or back while sleeping.
- Wedging. Being caught in a narrow space that causes interference
with chest wall movements and normal breathing (e.g., infant wedged
between mattress and bed frame).
- Infant’s Medical History
This section is filled out by the person investigating the infant’s
death. This information may be obtained from the infant’s health care
provider, medical record, or caregiver.
- Metabolic disorder. A disease that affects a person’s ability to use or
metabolize food (e.g., Medium chain acyl-CoA dehydrogenase (MCAD)
deficiency).
- Birth defect. A physical or functional abnormality that the infant had at
birth (e.g., spina bifida, congenital heart defect, Down syndrome)
- Newborn screen. Tests done at birth to detect certain metabolic disorders.
- Infant Dietary History
This section is filled out by the person investigating the infant’s death.
The information should be obtained from the person who last fed the infant.
If that person is not the person who usually fed the infant, also interview
the infant’s usual feeder.
- Pregnancy History
This section is filled out by the person who interviews the biological or
birth mother or someone who knows her history well (e.g., her health care
provider, partner, or mother).
- Incident Scene Investigation
This section is filled out by the person investigating the infant’s death.
- Investigation Summary
Investigators use this section to describe any concerns they have that
are not documented in the preceding sections of the form. Investigators may
use the checkboxes to indicate when tasks, such as doll
reenactment, are completed.
- Investigation Diagrams
Scene Diagram. The investigator indicates the following on the scene
diagram:
- North direction.
- Windows and doors.
- Wall lengths and ceiling height.
- Location of furniture, including infant’s bed or sleep surface.
- Location of infant’s body when found.
- Position of other people or animals found near the infant.
- Location of heating and cooling devices and other objects in room.
Body Diagram. The investigator indicates the following on the body
diagram:
- Discoloration around face, nose, or mouth.
- Secretions (drainage or discharge from anywhere on the body).
- Skin discoloration (livor mortis).
- Pressure mark areas (pale areas, blanching).
- Rash or petechiae (small, red blood spots on skin, on membranes, or in
eyes).
- Marks on body (scratches or bruises).
- Location of medical devices (e.g., breathing tube, gastrostomy feeding
tube).
- Body temperature.
- Summary for Pathologist
This section summarizes all the information collected during the witness
interview and during the investigation at the incident or death scene. This section
should be completed last by the person investigating the infant’s death.
- Asphyxia. Condition of severely deficient supply of oxygen to the body
that can rapidly lead to unconsciousness and death (e.g., compression of
infant’s chest because he was wedged into a narrow space or had a person
lying on him).
- Overlying. Situation in which someone or something is placed on or over
the infant.
- Hyperthermia. Life-threatening condition in which the core body
temperature is above 40°C (104°F).
- Hypothermia. Life-threatening condition in which the core body temperature
falls below 35°C (95°F).
Using the SUIDI Additional Investigative Forms
Additional investigative forms can be used by
death scene investigators to collect information about the
circumstances surrounding a sudden, unexplained infant death and
to document personal contacts and collection of evidence. While
these forms can be used in addition to the SUIDI Reporting Form
to collect important investigative information, this information
is not thought to be essential prior to autopsy.
These forms are designed
as a questionnaire. The death scene investigator can read the
questions to
the person they are interviewing. Most questions can be answered
by placing an “x” in the corresponding checkbox or filling in
the blank provided. Each of these forms can be used alone, or if
desired by the local jurisdiction, they can be used with the
SUIDI
Reporting Form.
Listed below is the name and purpose of each
investigative form and definitions of terms not commonly
recognized.
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Body Diagram
PDF 295KB
This diagram is a larger version of the
diagram included in the SUIDI Reporting Form. It can be used
in place of the smaller version. The diagram can be used to
note bruises, discoloration and other observations such as
the following:
- Discoloration around face, nose, or mouth.
- Secretions (drainage or discharge from anywhere on
the body).
- Skin discoloration (livor mortis).
- Pressure mark areas (pale areas, blanching).
- Rash or petechiae (small, red blood spots on skin,
on membranes, or in eyes).
- Marks on body (scratches or bruises).
- Location of medical devices (e.g., breathing tube,
gastrostomy feeding tube).
- Body temperature.
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EMS
Interview
PDF 821KB
The investigator uses this form to gather
information from emergency medical service (EMS) personnel who
responded to the scene. It can be used to augment the EMS run
sheet if the sheet is not available.
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Hospital Interview
PDF 461KB
The investigator uses this form to gather
information from the hospital emergency department personnel
who treated the infant. This form can be used to augment the
hospital records. The form can be used to interview hospital
personnel if the medical records are not available.
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Immunization Record
PDF 228KB
The investigator uses this form to document all
immunizations the infant received since birth. The
investigator can get this information from the parent or
caregiver’s immunization records or from medical records at
the infant’s clinic. To date, there is no evidence
supporting an association between immunizations and SIDS.
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Infant Exposure History
PDF 628KB
The investigator uses this form to identify all
persons who were in contact with the infant in the 24 hours
before the infant’s death. This form may be used to
document day care contacts or people attending large family
or community gatherings.
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Informant Contact
PDF 143KB
The investigator uses this form to track
contact information for each person interviewed.
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Law Enforcement Interview
PDF 842KB
The investigator uses this form to gather
information from law enforcement personnel who responded to
the scene. This information can be collected from interviews
with law enforcement personnel and by reviewing law
enforcement reports.
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Materials Collection Log
PDF 223KB
The investigator uses this form to keep a
detailed, descriptive list of all items recovered from the
incident or death scene.
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Nonprofessional Responder Interview
PDF 133KB
The
investigator uses this form to gather information from the
first nonprofessional (e.g., caregiver, neighbor) who
responded to the infant at the scene.
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Parental Information
PDF 97KB
The investigator uses
this form to gather contact information about the infant’s
mother, father and/or other primary caregivers.
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Primary Residence Investigation
PDF 784KB
The investigator uses
this form to describe the infant’s primary residence if the
incident or death did NOT occur at the primary residence.
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Scene Diagram
PDF 113KB
The investigator uses
this form to diagram multiple scenes or when a larger
diagram is needed to document the scene. This form is used
to document the immediate area surrounding the infant when
the infant was discovered dead, unresponsive, or in distress.
The investigator uses the form to record observations, such
as the following:
- North direction.
- Windows and doors.
- Wall lengths and ceiling height.
- Location of furniture, including infant’s bed or
sleep surface.
- Location of infant’s body when found.
- Position of other people or animals found near the
infant.
- Location of heating and cooling devices and other
objects in room.
Training Material
The SUIDI training text was developed to help those who
investigate infant deaths, and it was used at the SUIDI national
training academies.
50-State
Summary of SIDS Laws* (The National Conference of State
Legislatures)
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Page last reviewed:
6/10/08
Page last modified: 6/10/08
Content source: Division
of Reproductive Health,
National Center for Chronic
Disease Prevention and Health Promotion
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