Difficult Situation on Complete Response to Sudden Infant Death in Korea - Suggestion of Plans to Overcome

ABSTRACT

PURPOSE: To call on health authorities to construct an organized surveillance and investigation system with national financial support for sudden unexpected infant death (SUID) in Korea. METHODS: A single-center retrospective study was conducted on 19 SUID cases, including an analysis of vital statistics for Korean infants, estimation of costs, and suggestion of plans. RESULTS: SUID is the second most common cause of infant deaths in the ER. Most of the deceased infants in this study were discovered in a prone position and bystanders had not in any of the cases started cardiopulmonary resuscitation (CPR) at the scene. Immediate intraosseous (IO) access was not performed in the ER. All cases were categorized as "unclassified sudden infant death" according to the San Diego definition because autopsies and various screening tests were not performed. The assumed rate of incidence of SUID in Korea is 0.3~0.56 per 1000 live births per year. The cost for a response per SUID case was estimated to be over one million won. CONCLUSION: 1) Immediate launching of nation-wide "back-to-sleep campaign" is urgent. 2) Certification in infant resuscitation and prevention of sudden infant death syndrome (SIDS) should be required for workers in day care centers, orphanages or caregivers companies. 3) IO access should be performed immediately for infant cardiac arrest cases in the ER. 4) A nation-wide campaign would also be helpful to change irrational ideas about dead bodies, get public agreement on performing autopsies and raising the autopsy rate. 5) Legislation should be promoted to mandate autopsies and to organize and maintain a surveillance and investigation system with multi-agency support.