Suggestions to prevent child deaths

BURLEY, Idaho – Public health agencies, law enforcement, coroners, child care workers and parents all need to change their ways to help prevent child deaths, the Idaho Child Fatality Review Team recommends.

Team members will take their April report back to the agencies they represent, said Kirt Naylor, chairman of the Governor’s Task Force on Children at Risk. Some agencies already are discussing how to incorporate the team’s recommendations into existing programs.

Other components will wait for the governor’s office to allocate funding.

Gov. C.L. “Butch” Otter’s office received the recommendations last month and is still reviewing them, spokesman Jon Hanian said; it’s too early to say what funding may be allocated.

A sampling of the team’s recommendations:

Death certificate coding

Coroners should seek additional training on coding the cause and manner of death on death certificates, the team said.

The historical use of SIDS (sudden infant death syndrome) as a cause of death contributes to confusion in categorizing unexplained infant deaths, the team contends. A death should be coded as SUID (sudden unexpected infant death) only when all external causes are ruled out. Coroners should work with law enforcement agencies to complete a thorough investigation in these deaths.

The team recommends that coroners and the Idaho Bureau of Vital Records and Health Statistics eliminate the use of SIDS as a cause of death.

Vicki Armbruster, president of the Idaho Association of County Coroners, said she intends to ask coroners who served on the fatality review team to provide training during one of the association’s upcoming conferences.

The association offers training during its two conferences a year.

“We would like to have all of the coroners here every time, but that’s not possible for some of them,” Armbruster said.

Some of Idaho’s county coroners and deputy coroners are part-time, and it is difficult to take time off from other employment to attend training, said Erwin Sonnenberg, a retired Ada County coroner who served on the review team.

In smaller counties, coroners may not have as much experience or case load to keep their skills tuned up.

“That problem is not unique to Idaho,” Sonnenberg said.

Safe sleep education

Public health agencies should promote safe sleep practices to parents and medical professionals, and should do public education campaigns on CPR certification for parents and child supervisors, drowning prevention and the risk to infants of smoking parents, the fatality review team recommends.

Tom Shanahan, spokesman for the Idaho Department of Health and Welfare, said the public health division held meetings on how some of the recommendations can be incorporated into existing programs. The agency can speak with parents about safe sleep practices through the Nurse Home Visiting Program and relay the dangers of smoking through the Tobacco Prevention program.

“We may also be able to talk to the health districts about child care providers being trained in safe sleeping practices,” he said.

State licensing for child care providers requires pediatric rescue breathing, infant and child CPR and first aid training, Shanahan said.

Other recommendations would require the governor’s office to allocate money.

Lessons for parents

Health care providers should educate patients on the known risk factors of infant stomach sleeping, sleeping on soft surfaces and loose bedding, bed sharing and co-sleeping, the team said.

Hospitals that deliver babies are mandated by state law to provide training on proper sleep technique for infants, smoking cessation and the dangers of secondhand smoke, said Nancy Handy, manager of the Birth Center at Cassia Regional Medical Center.

The training is offered in multiple languages through a translation program.

Some parents disregard the training, Handy said, because a previous child did not have negative effects from an improper sleep position or co-sleeping with a parent. “It worked for them that time, so they continue to do it.”

Handy said Cassia Regional has only full-term babies, who are at lower risk for SUID than preterm infants.

“If there are other ways to get this information out to the public like through the WIC (Women, Infants and Children) program, I think it would be fabulous,” Handy said.

ATV safety certification

The team recommends that ATV riders take a safety certification course and wear helmets, eye protection and other protective gear. Children should ride only during daylight, and nobody should ride while drinking alcohol or using drugs. Children riders should never be allowed to have a passenger.

Cassia County Sheriff’s Office offers an ATV certification course, Undersheriff George Warrell said. “But there is not a lot of participation in it.”

The sheriff’s department holds patrol campaigns in the South Hills a few times a year, but the county has so many recreational areas it is impossible to patrol them all, Warrell said.

Education on safe ATV use has to be geared toward parents because it comes down to parental supervision, he said.

“When we see a child get hurt on an ATV it is usually related to lack of supervision or the parents are letting a child ride a machine that is too big,” Warrell said. “Parents need to be the parents. They are the supervisors, and sometimes it just doesn’t happen.”

Read More: Find a full list of recommendations in the Idaho Child Fatality Review Team’s report:  www.idcartf.org/ pages.php?page=Child+Fatality+ Review+Team