Therefore, according to our battered child protocol, the standard radiographs, following the guidelines of the American College of Radiography were performed.

Although the clinical history and findings during resuscitation suggested food aspiration, questions regarding the cause of death remained. To gain venous access, an intraosseous infusion (IOI) needle was placed in the right tibia.Īt 5:00 a.m., she was pronounced deceased. Several attempts were made to insert a central venous and arterial catheter, however, to no avail. During resuscitation, significant amounts of food were aspirated from her mouth and endotracheal tube. Upon physical examination, a non-responsive child without spontaneous respiration or cardiac output was seen. They arrived in our hospital approximately 45 min after the 911 call. The latter was first to arrive and transported the girl and her mother to the emergency department of the Academic Medical Centre Amsterdam.

A 911 call was placed, and a friend of the family was called.

During feeding, she started to vomit and became unresponsive. Vaccinations were given according to the Dutch vaccination program.Īccording to the mother, the child awoke at 3 ‘o clock at night and, as what had happened before, her mother bottle fed her. Outpatient follow-up showed no other medical problems.

She was known in our hospital because of prematurity (gestational age, 30 weeks) and an omphalocele, for which initial non-operative treatment with epithelialisation was instituted, and delayed surgical correction was planned. A 7-month-old girl was admitted to our emergency department.

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