Algorithm By Briana Schafer Clinical Definitions Induced OR Spontaneous AB Fetus lt 20 weeks gestational age or lt23 weeks from LMP or lt 500g if GA and LMP not known AND diagnosed as ID: 260169
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Slide1
Fetal Demise/Neonatal Death Algorithm
By,
Briana SchaferSlide2
Clinical DefinitionsSlide3
Induced OR Spontaneous AB.
Fetus < 20 weeks gestational age, or <23 weeks from LMP, or < 500g if GA and LMP not known, AND diagnosed as
fetal death. Slide4
Was
Stillbirth
Fetus >20 weeks, LMP > 23 weeks, or > 500 g if gestational age and LMP not known AND
born dead.
Was fetus alive on admission with documented heart tones?
Baby issued a
Fetal Death Certificate,
NO BIRTH CERTIFICATE
If YES,
Intrapartum
Fetal Death
If NO,
Antepartum
Fetal Death
Follow Policy & Procedure protocol.
Notify NM/HS.
Notify One Legacy w/in 1 hour of delivery, fill out form with # they give you
State law requires burial or cremation of infant. Discuss plans with parents and social services. Obtain signed Release to Mortuary/Coroner form with name of mortuary selected by parents
If parents refuse to dispose of remains, obtain signed Permit to Retain and Dispose form.
Parents will be billed.
Obtain weight and length of infant. If appropriate complete memory box with footprints, use digital camera for photos.
Place appropriate ID bands on baby (if neonatal death, use assigned MRN)). Wrap in
chux
, label outside with mother’s name/MRN/delivery data & time/sex of infant/baby’s stillbirth or MRN.
Bring infant to
morgue
, chart to Decedent Affairs (if no autopsy) IN PERSON on day of deathSend placenta to Pathology with pathology requisition including delivery data & time, notation of infant death, gestational age
Primary NURSE: Refer to Social Services BEFORE delivery and give bereavement services packet “Resolve Through Sharing.”Notify NM/HS. Notify One Legacy w/in 1 hour of delivery, fill out form with # they give youState law requires burial or cremation of infant. Discuss plans with parents and social services. Obtain signed Release to Mortuary/Coroner form with name of mortuary selected by parentsIf parents refuse to dispose of remains, obtain signed Permit to Retain and Dispose form. Parents will be billed.Obtain weight and length of infant. If appropriate complete memory box with footprints, use digital camera for photos.Place appropriate ID bands on baby (if neonatal death, use assigned MRN). Wrap in chux, label outside with mother’s name/MRN/delivery data & time/sex of infant/baby’s stillbirth or MRN.Notify transport & security, bring infant to morgue, chart to Decedent Affairs (if no autopsy) IN PERSON on day of deathSend placenta to Pathology with pathology requisition including delivery date & time, notation of infant death, gestational age
IF AUTOPSY/SPECIAL EXAM DESIRED BY MD:
MD to fill out Autopsy Consultation form and notify pathologist on callMD to fill out Autopsy Consent form, obtain parent signature, RN witnessForm 18 filled out ONLY for Coroner’s cases. MD to call Coroner. Coroner’s cases include criminal abortions, drug abuse, gunshot/poisoning, other criminal activity (see Coroner criteria for complete listing).UCLA Autopsy form filled out only for HIV or Creutzfeldt-Jakob Syndrome disease cases only.Yellow AUTOPSY CASE form goes on top of chart, chart goes to Pathology. Baby goes to morgue. Charge/Primary nurse to notify Decedent Affairs.Slide5
Neonatal Death
Fetus is any gestational age,
born alive
with purposeful movement &/or vital signs and then
expires after delivery.
Use standard baby number
Complete standard L&D documentation
Admit and enter data into Health Connect
MD must pronounce Time of Death and document in progress note
Have parents complete birth certificate worksheet
Baby will be issued standard birth
AND
death certificate
Primary NURSE: Refer to Social Services
BEFORE delivery
and
give
bereavement services packet “Resolve Through
Sharing”
Notify NM/HS.
Notify One Legacy w/in 1 hour of delivery, fill out form with # they give youState law requires burial or cremation of infant. Discuss plans with parents and social services. Obtain signed Release to Mortuary/Coroner form with name of mortuary selected by parentsIf parents refuse to dispose of remains, obtain signed Permit to Retain and Dispose form. Parents will be billed.Obtain weight and length of infant. If appropriate complete memory box with footprints, use digital camera for photos.Place appropriate ID bands on baby (if neonatal death, use assigned MRN). Wrap in
chux
, label outside with mother’s name/MRN/delivery data & time/sex of infant/baby’s stillbirth or MRN.Notify transport & security, bring infant to
morgue, chart to Decedent Affairs (if no autopsy) IN PERSON on day of deathSend placenta to Pathology with pathology requisition including delivery date & time, notation of infant death, gestational age
IF AUTOPSY/SPECIAL EXAM DESIRED BY MD:
MD to fill out Autopsy Consultation form and notify pathologist on callMD to fill out Autopsy Consent form, obtain parent signature, RN witness
Form 18 filled out ONLY for Coroner’s cases. MD to call Coroner. Coroner’s cases include criminal abortions, drug abuse, gunshot/poisoning, other criminal activity (see Coroner criteria for complete listing).UCLA Autopsy form filled out only for HIV or Creutzfeldt-Jakob Syndrome disease cases only.Yellow AUTOPSY CASE form goes on top of chart, chart goes to Pathology. Baby goes to morgue. Charge/Primary nurse to notify Decedent Affairs.Slide6
Kaiser Permanente Medical Center Perinatal Services
Fetal Demise/Neonatal Death Algorithm
Induced OR Spontaneous AB.
Fetus
< 20 weeks gestational age,
or <23
weeks from LMP, or <
500g
if
GA and LMP
not
known, AND diagnosed
as
fetal death.
Stillbirth
Fetus
>20 weeks,
LMP >
23 weeks, or
>
500 g if gestational age and LMP not known AND born dead.
Neonatal Death
Fetus is any gestational age,
born alive
with purposeful movement &/or vital signs and then expires after delivery.
Was fetus alive on admission with documented heart tones?
Use standard baby numberComplete standard L&D documentationAdmit and enter data into Health Connect
MD must pronounce Time of Death and document in progress noteHave parents complete birth certificate worksheetBaby will be issued standard birth AND death certificate Refer to Social Services BEFORE delivery and give bereavement services packet “Resolve Through Sharing.”Notify NM/HS. Notify One Legacy w/in 1 hour of delivery, fill out form with # they give youState law requires burial or cremation of infant. Discuss plans with parents and social services. Obtain signed Release to Mortuary/Coroner form with name of mortuary selected by parentsIf parents refuse to dispose of remains, obtain signed Permit to Retain and Dispose form. Parents will be billedObtain weight & length of infant. If appropriate, complete memory box with footprints, use digital camera for photosPlace appropriate ID bands on baby (if neonatal death, use assigned MRN)). Wrap in chux, label outside with mother’s name/MRN/delivery data & time/sex of infant/baby’s stillbirth or MRNNotify transport & security, bring infant to morgue,
chart to Decedent Affairs (if no autopsy) in person
on day of deathSend placenta to Pathology with pathology requisition including delivery date & time, notation of infant death, gestational age
IF AUTOPSY/SPECIAL EXAM DESIRED BY MD:
MD to fill out Autopsy Consultation form and notify pathologist on call
MD to fill out Autopsy Consent form, obtain parent signature, RN witness
Form 18 filled out ONLY for Coroner’s cases. MD to call Coroner. Coroner’s cases include criminal abortions,
drug abuse
, gunshot/poisoning, other criminal activity (see Coroner criteria for complete listing).
UCLA Autopsy form filled out
only
for HIV or Creutzfeldt-Jakob Syndrome disease cases only.
Yellow AUTOPSY CASE form goes
on top of chart
, chart goes to Pathology. Baby goes to morgue. Charge/Primary nurse to notify Decedent Affairs.Slide7
Management of the Body
INDUCED/SPONTANEOUS ABORTION or STILLBIRTH
If fetus is 20 weeks or less (Induced/Spontaneous Abortion), parents must REQUEST cremation. Slide8
Management of the Body
NEONATAL DEATH
AFTER DELIVERY OF BABYSlide9
Management of the Body
STILLBIRTH/NEONATAL DEATH
AFTER ALL PROCEDURES ARE DONE AND FAMILY IS FINISHED VIEWING THE BABY