Comparison of two infant cardiopulmonary resuscitation techniques explained by phone in a non-health professionals' population: Two-thumbs encircling hand technique vs. two-fingers technique, a randomised crossover study in a simulation environment.

BACKGROUND: Paediatric out-of-hospital cardiac arrest (OHCA) is the reason for an emergency call in approximately 8/100,000 person-years. Improvement of OHCA resuscitation needs a quality chain of survival and a rapid start of resuscitation. The aim of this study was to compare the efficacy of two resuscitation techniques provided on a mannequin, the two-fingers technique (TFT) and the two-thumbs encircling hand technique (TTHT), explained by a trained emergency call responder on the phone in a population of non-health professionals. METHODS: We conducted a randomised crossover study in the simulation lab of a University Hospital. The participants included in the study were non-health professional volunteers of legal age. The participants were assigned (1:1 ratio) to two groups: group A: TFT then TTHT, group B: TTHT then TFT. Scenario and techniques were discovered during the evaluation. RESULTS: Thirty-five volunteers were randomised before the sessions and 33 ultimately came to the simulation lab. We found a better median QCPR global score during TTHT sessions than during TFT sessions (74 vs. 59, P = 0.046). Linear mixed models showed that the TTHT method was the only variable associated with a better QCPR global score [model 1: ß = 14.3; 95% confidence interval (CI), 2.4-26.2; model 2: ß = 14.5; 95% CI, 2.5-26.6]. CONCLUSION: Our study showed the superiority of TTHT for infant CPR performed by non-health professionals when an emergency call responder advised them over the phone. It seemed to be the best technique for a solo rescuer regardless of previous training.

Newborn Life Support course: does it make me more confident when resuscitating a newborn?

AIM: To describe the effectiveness of the Newborn Life Support (NLS) course in terms of attendees' knowledge, perceived self-efficacy, and clinical applicability. METHODS: We conducted an electronic survey of NLS course attendees (NLS + group). A control group (NLS-) was recruited via our regional perinatal network. The survey data were analyzed anonymously. Multiple linear regression analysis examined the following: NLS course, job tenure, maternity level, and profession. RESULTS: The survey completion rate was 62% (200/323) for the NLS + group. Among participants, 84% had participated in neonatal resuscitation since their course. The scores for positive perceived experience for neonatal resuscitation (fluency, security, and quality of care delivered) were higher in the NLS + group than the NLS- group (p<.006). After adjustment, the independent factors associated with a higher positive perceived experience were the NLS course, work in tertiary level maternity ward, and job tenure >5 years. The multiple-choice questions (MCQs) score (n = 10) was 8.2 ± 1.3 (NLS+) vs. 6.7 ± 1.5 (NLS-) (p<.0001). NLS course, medical degree, and work in a tertiary level maternity ward were independently associated with higher knowledge scores. CONCLUSIONS: The NLS course was associated with a positive perceived experience regarding neonatal resuscitation.Key notesNeonatal resuscitation training programs, like the Newborn Life Support (NLS), have been developed to improve the management and outcomes of newborns with poor adaptation at birth.The NLS course was associated with better knowledge of, and a positive perceived experience (fluency, safety, and quality of care delivered) regarding, neonatal resuscitation.Participation to the NLS course seems to strengthen the perceived self-efficacy in healthcare professionals, which is critical to performing neonatal resuscitation.

Disaster preparedness in French paediatric hospitals 2 years after terrorist attacks of 2015.

OBJECTIVE: We aimed to determine paediatric hospital preparedness for a mass casualty disaster involving children in both prehospital and hospital settings. The study findings will serve to generate recommendations, guidelines and training objectives. DESIGN AND SETTING: The AMAVI-PED study is a cross-sectional survey. An electronic questionnaire was sent to French physicians with key roles in specialised paediatric acute care. RESULTS: In total, 81% (26 of 32) of French University Hospitals were represented in the study. A disaster plan AMAVI with a specific paediatric emphasis was established in all the paediatric centres. In case of a mass casualty event, paediatric victims would be initially admitted to the paediatric emergency department for most centres (n=21; 75%). Paediatric anaesthesiologists, paediatric surgeons and paediatric radiologists were in-house in 20 (71%), 5 (18%) and 12 (43%) centres, respectively. Twenty-three (82%) hospitals had a paediatric specialised mobile intensive care unit and seven (25%) of these could provide a prehospital emergency response. Didactic teaching and simulation exercises were implemented in 20 (71%) and 22 (79%) centres, respectively. Overall, physician participants rated the level of readiness of their hospital as 6 (IQR: 5-7) on a 10-point readiness scale. CONCLUSION: Paediatric preparedness is very heterogeneous between the centres. Based on the study findings, we suggest that a national programme must be defined and guidelines generated.

[Sudden unexpected death in infancy]. / Mort inattendue du nourrisson.

Unexpected death in infancy. Sudden unexpected death in infancy (SUDI) is an entity that, after a thorough investigation, includes unexplained deaths and deaths for which a cause is found. Although the number of SUDI fell sharply after the "Back to Sleep" campaign in the 1990s, it currently accounts for nearly 500 deaths per year in France. In 2007, the Haute Autorité de santé issued guidelines to specify the missions and the methods of cooperation of the various care professionals in case of SUDI. The pre-hospital emergency team has a vital role in gathering information at home. Post-mortem investigations and care of the child's relatives should continue in a SUDI Reference Center. The purpose of these guidelines is a better understanding of the causes of death for improved prevention.

Mort inattendue du nourrisson. La mort inattendue du nourrisson est une entité regroupant, après une investigation approfondie, des morts restant inexpliquées (mort subite du nourrisson) et des morts pour lesquelles une cause est retrouvée. Bien que le nombre de morts inattendues du nourrisson ait fortement diminué après la campagne de prévention en faveur du couchage dorsal dans les années 1990, il concerne actuellement près de 500 décès annuels en France. La Haute Autorité de santé a publié en 2007 des recommandations pour préciser les missions et les modalités de coopération des différents intervenants en cas de mort inattendue du nourrisson. L'équipe médicalisée intervenant au domicile a un rôle essentiel de recueil d'informations. Les investigations post-mortem et la prise en charge des proches de l'enfant doivent se poursuivre dans un centre de référence « mort inattendue du nourrisson ¼. L'objectif de ces recommandations est une meilleure compréhension des causes des décès pour une amélioration de leur prévention.

[Emergency medical aid in a paediatrics context]. / L'aide médicale urgente en contexte pédiatrique.

In France, the organisation of aid involves the intervention of the emergency medical services (Samu), which coordinate the medical regulation platforms for site 15 and the mobile emergency and intensive care services (Smur). Since they were created, the Samu have been tirelessly adapting their response to the various characteristics of pre-hospital assignments. Pre- and inter-hospital paediatrics has seen the development of specialised teams with the aim of providing effective aid which is adapted to the youngest and most vulnerable patients.