Table 1

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

SampleSend to:HandlingTest
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 mlClinical chemistryNormalUrea and electrolytes
Blood (serum) 1 mlClinical chemistrySpin, store serum at −20°CToxicology
Blood (lithium heparin) 1 mlClinical chemistrySpin, store plasma at −20°CInherited metabolic diseases
Blood (fluoride) 1 mlClinical chemistrySpin, store plasma at −20°C3-OH butyrate, sugar, FFA, lactate
Blood EDTA 0.5 mlHaematologyNormalFBC
Blood cultures—aerobic and anaerobic 1 mlMicrobiologyIf insufficient blood, aerobic onlyCulture and sensitivity
Blood from syringe onto Guthrie cardClinical chemistryNormal (fill in card—do not put into plastic bag)Inherited metabolic diseases
Blood (lithium heparin) 5 mlCytogeneticsNormal—keep unseparatedChromosomes (if dysmorphic)
CSF (a few drops)MicrobiologyNormalMicroscopy, culture and sensitivity
CSF 0.5 mlClinical chemistryStore at −20°CInherited metabolic diseases
Swabs from any identifiable lesionsMicrobiologyNormalCulture and sensitivity
1. Urine (if available)Clinical chemistrySpin, store supernatant −20°CToxicology, inherited metabolic diseases
2. Urine (few drops, if above sample taken)MicrobiologyNormalMicroscopy, culture and sensitivity