death review nov 2010

8/3/2019 Death Review Nov 2010

http://slidepdf.com/reader/full/death-review-nov-2010 1/21



Period Admission Death % of Deaths

01.11.2010

to30.11.2010

76 3 3.95%



Name Age Cause of Death

Tinni 4 months

Severe acute malnutrition (wasting

type) with Keratomalacia withSepticaemia

Hafsa 3 monthsDown’s Syndrome with Pneumonia

with HF

Sajib 10 years AML with Hepatitis



Tinni, 4 months old partially immunized female infant, weighing 2.5 kg, 2nd issue (1st twin)of non consanguineousparents, hailing from Narayanganj, Dhaka was admitted inDMCH on 3rd November at 10:30PM with the complaints of

fever for 7 days, cough for same duration, respiratory distressfor 3 days and reluctant to feed for 2 days.



According to statement of informant mother, she wasreasonably well 7 days back. Then she developed fever withcough which was low grade initially, and fever turned to highgrade for last 3 days. Her fever was continuous in nature, and

associated with cough and respiratory distress. The baby wasreluctant to feed for last 2 days. With these complaints she

was treated by local doctors. Her birth history was un-

eventful. After birth, she was on breast milk for first few

days. Then diluted formula milk (Lactogen -1) was givenoccasionally with breast milk. She had history of repeated attack of diarrhoea since birth.



On admission, patient was ill looking, cachectic, dyspnoeic. Mildy anaemic. Jaundice, Cyanosis was absent. Baby was non-edematous,not dehydrated. Opacity was present in both eyes. Temp 102oF, RR-68/min, HR – 140 b/min. Chest indrawing was present. There wascrepitation over both lung fields. On abdominal examination, liver was palpable about 3c.m. from MCL. Other systemic examinationsrevealed normal findings. BCG mark was present in left upper arm.There was no change in skin and hair. Bed side urine albumin was nil.CBG was 7.0 mmol/L.

Regarding anthropometry : Weight 2.5 kg, length 51 cm

Wt for length on -5.2 SD

Length for age on -4.1 SD

Wt for age on -5 SD



CBC with PBF

ESR

Blood grouping & Rh typing

CXR Urine R/M/E & culture – sensitivity

Serum electrolytes



We started NG tube feeding with F-75 diet 2hourly total 12 feeds/day.

Total fluid – 100 ml/kg /day

Total calorie – 75 kcal /100 ml

Protein - 1.0 gm / 100 ml



O2 inhalation (1L/min)

Inj. Ampicillin

Inj. Gentamycin Inj. MgSO4

Syp. Zinc

Syp. KT

Tab. Folison

Cap. Retinal Forte

Aprocin eye drop

Homatropin eye drop Tetracycline eye ointment

Syp. Paracetamol

Nebulization



CBC : Hb – 7.2 gm/dl

TC – 18000/cu mm

DC - N 50 %

L 40 % Platelet count - 200000/cumm

Blood group : B (+) ve

Other investigation reports were not available.



Ill looking, dyspnoeic

Chest indrawing present

Temp. - 1000F

Heart rate – 130 b /min Respiratory rate – 62 /min

Heart – NAD, Lungs – Crepitation present allover

the lung field Abdomen – Soft, non-tender

Treatment continued



Ill looking

Resp. Distress present


Temp. - 1010F

Heart rate – 128 b /min

Respiratory rate – 72 /min

Heart – NAD, Lungs – Crepitation present alloverthe lung field

Treatment continued



Ill looking



Temp. - 990F




Rx Added

Inj. Ceftriaxone








Rx Added

O2 inhalation 2L/min by N/C



Pt. was lethargic

Gasping breathing


Pupil dilated, and notreacting to light

Rx Added O2 inhalation 4L/min by H/B



Gasping breathing continued


Pupil dilated and fixed, notreacting to light

Reflex activity poor

Rx Added Ambu bag ventilation given



Cessation of breath

No audible Heart sound

Pupil dilated and fixed, notreacting to light

Reflex activity absent

CPR started



No respiration

No Heart beat Pupil dilated and fixed, not

reacting to light

Reflex activity absent

There was no sign of life



Patient was declared clinically deadat 06:10PM on 04.11.2010



Cardio respiratory failure due to severe acutemalnutrition with Keratomalacia with

Septicaemia



Thank You

death review nov 2010

Documents