Table 1

Initial samples to be taken immediately after sudden unexpected death in infancy (SUDI)²

Sample	Send to:	Handling	Test
Any postmortem investigations need to be agreed with the coroner. Often this can be agreed in advance as a standard protocol. Most investigations can safely be done at necropsy.
CSF, cerebrospinal fluid; EDTA, ethylene diamine tetraacetic acid; FBC, full blood count; FFA, free fatty acid; OH, hydroxy.
Blood (serum) 0.5 ml	Clinical chemistry	Normal	Urea and electrolytes
Blood (serum) 1 ml	Clinical chemistry	Spin, store serum at −20°C	Toxicology
Blood (lithium heparin) 1 ml	Clinical chemistry	Spin, store plasma at −20°C	Inherited metabolic diseases
Blood (fluoride) 1 ml	Clinical chemistry	Spin, store plasma at −20°C	3-OH butyrate, sugar, FFA, lactate
Blood EDTA 0.5 ml	Haematology	Normal	FBC
Blood cultures—aerobic and anaerobic 1 ml	Microbiology	If insufficient blood, aerobic only	Culture and sensitivity
Blood from syringe onto Guthrie card	Clinical chemistry	Normal (fill in card—do not put into plastic bag)	Inherited metabolic diseases
Blood (lithium heparin) 5 ml	Cytogenetics	Normal—keep unseparated	Chromosomes (if dysmorphic)
CSF (a few drops)	Microbiology	Normal	Microscopy, culture and sensitivity
CSF 0.5 ml	Clinical chemistry	Store at −20°C	Inherited metabolic diseases
Swabs from any identifiable lesions	Microbiology	Normal	Culture and sensitivity
1. Urine (if available)	Clinical chemistry	Spin, store supernatant −20°C	Toxicology, inherited metabolic diseases
2. Urine (few drops, if above sample taken)	Microbiology	Normal	Microscopy, culture and sensitivity