SINGAPORE: KK Women's and Children's Hospital (KKH) is reviewing its procedures to consider continuous documentation of a newborn’s vital signs, after a baby died of a type of injury that stems from a decrease in oxygen or blood flow to the brain. State Coroner Adam Nakhoda encouraged the hospital to imp
SINGAPORE: KK Women's and Children's Hospital is reviewing its procedures to consider continuous documentation of a newborn’s vital signs, after a baby died of a type of injury that stems from a decrease in oxygen or blood flow to the brain.
His mother had been admitted to KKH at 39+1 weeks of pregnancy, and had gestational diabetes mellitus during her pregnancy as well as a prior history of Graves’ disease - an immune system disorder that affects the thyroid gland. The CPAP was discontinued at six minutes post-delivery, with the baby observed to be vigorous and have a"good cry". The rest of the examination findings were normal.
She then took him out of the resuscitator, placed him on a transport cot and took him to the viewing room for his father to look at him. In the operating theatre, the nurse put the baby back on the resuscitator and attached a probe to him. He did not appear to be breathing spontaneously, so the nurse administered intermittent positive pressure ventilation using a resuscitator, before activating a neonatal code blue emergency at 5.22am.
He was treated for the seizures and referred to the neurology team for co-management, but later was found to have copious amounts of fresh blood in his mouth. The findings were communicated to the baby's parents, and they agreed after consideration on day six to actively withdraw care, with provision for sedation and pain medications.An autopsy found the cause of death to be hypoxic ischaemic encephalopathy . This is a type of brain dysfunction or injury that occurs when the brain experiences a decrease in oxygen or blood flow.
The baby was hooked up to a probe that would have recorded his oxygen saturation and heart rate, but there was no electronic record of these readings as they were not captured by KKH's electronic medical records system. The KKH representative said that after reviewing this aspect, the hospital is working to ensure documentation of a newborn's vital signs is kept until the newborn is handed over to medical teams at the respective clinical areas.
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