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When dealing with a baby in need of CPR, it's important to take note of any bruises or marks beforehand. Assess the environment and conditions where the infant was found. Be understanding and empathetic towards the family, allowing them to express grief and offering support. Avoid speculating on the cause of death and use appropriate language when discussing the situation. Offer to call a clergy or family member for support. After resuscitation attempts, do not remove any equipment used. It's important to address the emotional impact on caregivers and offer counseling if needed. Consider arranging home visits for closure. Take time off after such a difficult call and seek help if experiencing PTSD symptoms. Apparent life-threatening events in infants are characterized by changes in muscle tone, choking or gagging, and cyanosis. These patients should be assessed and transported to the hospital. Pediatric anatomy differs from adults, with larger heads in proportion to the body. Take special attention to any bruises or marks left before performing any procedures. If you see something, make note of it, because that may have something to do with the situation. Because once you start doing CPR on a baby, you're going to bruise the hell out of it. Anybody who gets CPR gets bruised, gets beat up. It's what happens. So you want to make note of things before you start. Oh yeah, there was a bruise to the upper chest before we started. Carefully inspect the environment, noting conditions on the scene and where the infant was found. Assessments should concentrate on signs of illness, general condition of the house, signs of poor hygiene, family interaction, and the site where the infant was discovered. Sudden death of an infant is devastating for the family. It tends to evoke strong emotions. Do not take it personally they're going to lash out. By the same token, don't become a verbal or physical punching bag. Allow the family to express grief. If you don't suspect child abuse, allow them to hold the child. Provide the family with empathy and understanding. Can I call somebody, a priest, a mullah, a rabbi, a family member, a friend, you know, that kind of thing. Get services there for the family, because they're going to need it. This isn't one of these where, oh, well, baby's gone, have a good day. Police will be on their way. You're not going to do that. You're going to spend time. This is a stay and play type of, like, I wouldn't say stay and play, but this is a, you're going to stay on scene for a while. You're going to be there for the family members. You're going to ensure you get the proper, they get the proper care. Do not speculate on the cause of the child's death. We don't diagnose things. We don't know. The family should be asked whether they want to hold the child. Following interventions are helpful. Use the child's name. Speak to the family member at eye level. God bless you. Don't use detailed medical terminology. God bless you. And use dead or died or death. Don't say things like passed away or gone or in a better place. You want to make sure that that family member takes, you know, accepts that. God bless you. Accepts that. Acknowledge the family's feeling. Never say I know how you feel. Don't do that, because you don't. Offer to call a family member or clergy. Discussion should be short, simple, and basic. Ask them if they want to hold the child, wrap the child in a blanket. Do not remove any equipment that was used during the resuscitation attempt. If you attempted resuscitation and you're getting dead, then the police come. They're going to take pictures, make note of stuff, and then you can leave. Death of a child. Everyone expresses grief in different ways. Some require intervention. Many caregivers feel directly responsible for the death of a child. It's a tough one. It's a tough one. You go to a call and you have to deal with the death of a child. Not easy. So, don't ignore yourself. Don't ignore your partner. If we deal with calls like that, we automatically offer counseling to the crews that are on scene. Usually, we or the fire departments will set up what they call a CISD, critical incident stress debriefing, where they have special counselors that work in this. They'll come out and do a brief session, a couple hours. Everybody sits around, and you just talk about your feelings. You talk about the call. You don't talk about medical, and this isn't an M&M round. I don't want to know what you did on the call. I want to know how you feel. Some EMS systems arrange for home visits after a child's death for closure. Obviously, you need some mental health training to do that, but if that's something you're interested in, you can ask your service if that's something that they offer. Child's death can be stressful for everybody. Take time off before going back. We usually say, you do a call like that, I usually pull you off the road, give you a couple hours, and then say, if you want to go home, if you want to get some treatment, what do you want to do? Talk to your other colleagues, be alert for that PTSD, and consider help. Infants who are not breathing, this is the ALT, apparent life-threatening event. This is funny because parents instinctively know it. Like, you'll get a call, and you're like, I don't know what happened. I just woke up in the middle of the night. I ran in the bedroom. My baby wasn't breathing, and I shook the baby, started breathing. It's weird. Parents just instinctively know. So, classic ALT will be distinct changes in muscle tone, choking or gagging. They'll be possibly cyanotic. Many times the parent will pick up the child, and the child will stop breathing. Complete an assessment and provide transport to the hospital. These patients will end up with apnea monitors. They'll be put on a strap that goes on the chest and be on for a few weeks, where they can monitor it. It sets off a really loud alarm when the heart rate or respiratory rate drops below a specific parameter. So, breathe, unrespond, unexplained event. Like an ALT. Breathe changes in color, such as pale skin or cyanosis, choking, absent flow, irregular breathing. You are normally found. Transport for evaluation. We don't just say, they just find out. So, what do we do? How does pediatric anatomy differ from the adult anatomy? The head is proportionally larger. The head is proportionally larger. We're born with a head 60% our adult size. We kind of grow into it.