DEATH REVIEW

PEDIATRICS UNIT

Presented by :
Dr. Mourita Saha
Resident (Phase-B)
Department of pediatrics
Dhaka medical college
Case Duration: 01-Jan-2022 to 31-Jan-
2022
Total no. Neonate No. of death Percentage of
death
361 207 45 21.7%
 No. of admission (child) Death percentage
154 12 7.7%
Death profiles
Name Age Diagnosis Duration of
hospital stay

B/O Lubna 1 day Preterm (32wks) with LBW (1800g) with 1 days

RDS

Humairah 50 Preterm (32wks) with LBW (1300g) with LONS 5 days

days with DIC

Death profiles
Name Age Diagnosis Duration of
hospital stay

B/O Rani 5day Term with IUGR with LONS 1 days

B/O 0 day Preterm (32wks) with LBW (1300g) with EONS 10 days

Kohinoor
Death profiles
Name Age Diagnosis Duration of
hospital stay

B/O Nazma 0 day Preterm (32wks) with LBW(1620g) 3 days

B/O Jesmin 1D Preterm (32wks) with ELBW(850g) 6 days

Death profiles
Name Age Diagnosis Duration of
hospital stay

B/O Sheema 0D Preterm (34wks) with LBW(1520g) 1D

B/O Amena 0D Preterm (34wks) with Incredibly LBW(1520g) 1 days

Death profiles
Name Age Diagnosis Duration of
hospital stay

B/O jamila 9D Preterm(28wks) with LBW (1300g) 8 days

B/O Lima 2D Term(39wks) with LBW(2370g) with PNA 1D

stage II
Death profiles
Name Age Diagnosis Duration of
hospital stay

B/O Shathi 0D 4D
Preterm(35wks) with LBW(1750g) with
PNA stage I with EONS

B/O Mukta 3D Preterm(28wks) with LBW(1150g) 1D

Case summery
Tayeba, 11 months old girl, 2nd issue of non-consanguineous parents, immunized as
per EPI schedule, belongs to low socioeconomic background, hailing from Goalpara,
Faridpur, admitted in our hospital at 1:00 om on 7.1.2022 with the complain of-

• Fever for 4 days

• Repeated episode of convulsion for 2 days.

• Drowsiness for 1 days.

• Respiratory distress and cough for 3 days

Fever was high grade, intermittent in nature, not associated with
chills & rigor, subsided after taking antipyretics. Convulsion was
generalized tonic clonic in nature, occurred repeatedly for 6-7
times, each episode last for 5-10 minutes, followed by
drowsiness for 1 day. He had no history of trauma, vomiting, ear
infection, abdominal pain, cough, cold ,contact with TB patient
or travelling to malaria or Kala azar endemic area. For this
complaints he took treatment at local hospital .
On examination, patient was found lathergic, GCS was 6/15, mildly
pale, anicteric, temp : 1020 F, HR : 100 b/m, RR- 60 b/m, CRT- 2 sec. on
skin survey BCG mark present, no lymphadenopathy, dehydration
absent, CBG 5.1 mmol/L regarding anthropometry weight was 7.2 kg
height was cm.
On systemic examination regarding nervous system GCS
6/15,signs of meningeal irritation absent. Cranial nerves normal as
I could examined, motor system of lower limbs revealed - bulk
normal, power 1/5, tone normal, jerks normal, planter extensor.
motor system examination of upper limb revealed same as lower
limb. Sensory examination could not be elicited.

On examination of respiratory system patient had fast breathing

60 b/min and crepitation in both lung fields

Other system revealed no abnormality.

Provisional diagnosis :

Meningoencephalitis
with
Pneumonia
Management
• Counselling was done to patient party about the condition of the
patient, treatment option and disease prognosis.
Treatment on admission

• Nothing per oral

• O2 inhalation

• Inf Electrodex 10

• Inj Dexamethasone

• Inj Ceftriaxone

• Supp. Paracetamol
• After initial treatment patient had active convulsion and we gave a
phenobarbitone loading dose.
Follow up
Date and time Follow up Measures taken
08.01.2022 Temp: 102°F • Inj. Virux
9 am H/R: 100b/min • NG tube feeding
R/R: 60 breaths/min • Vancomycin
Drowsy • Barbiturate BD
09.01.2022 Patient became unconscious Same as previous day
9 am Temp: 102°F
R/R: 44 b/min
H/R: 104 breaths/min
10.01.2022 Unconscious Same as previous day
9 am R/R: 34 b/min
H/R: 108breaths/min
Temp: 102°F
Further Follow up and management
Date and time Follow up Measures taken

11.01.2022 Temp: 100°F

6 am H/R: 100b/min
R/R: 50 breaths/min
CRT: 5 sec
Pupil: Mild dilated, partially reacting to light

7 am temp: 100°F
R/R: 20 b/min
H/R: 80 breaths/min
CRT: 4 sec
Pupil: mild dilated, partially reacting to light

Resp: Gasping CPR

8 am H/R: 50 b/min(feeble) Counselling
CRT: 5 sec
Pupil: dilated, not reacting to light

8:30 am H/R: non-recordable

No spontaneous respiration
Pupil: Dilated, not reacting to light
 Conclusion

Patient was declared clinically dead on 11/01/22 at 9.00 am.

We are sorry ..