Résumé
L’arrêt cardiorespiratoire (ACR) de l’enfant est dans la majorité des cas l’ultime conséquence d’une insuffisance respiratoire et/ou circulatoire. L’hypoxie étant la première cause, la prise en charge de l’ACR de l’enfant a des spécificités: manoeuvres de réanimation pendant une minute avant l’appel des secours, ratio 15/2 des compressions thoraciques et des insufflations chez l’enfant prépubère. Les troubles du rythme cardiaque, responsables de l’arrêt, les plus fréquents sont l’asystolie et l’activité électrique sans pouls. Les défibrillateurs automatiques externes (DAE) sont utilisables à partir de l’âge d’un an, si possible avec un atténuateur pédiatrique. La survie à un an des arrêts cardiaques reste très faible, grevée de séquelles neurologiques. La reconnaissance et la prise en charge précoce des défaillances respiratoires et circulatoires, surtout en milieu hospitalier, est la seule prévention de l’arrêt cardiaque. La formation des professionnels de santé est indispensable et représente un immense problème.
Abstract
Cardiac arrest in infants and children is most often due to the ultimate result of progressive respiratory failure or shock. Causal pathologies, mainly hypoxia, explain specific paediatric sequence of actions: basic life support for one minute before calling for help and chest compression/breath ratio of 15:2. Cardiac arrest rhythms are most often asystole or pulseless electrical activity. Automated external defibrillators are useful in children older than one year, ideally with a paediatric attenuating system. Recognition and management of respiratory and circulatory failures, particularly in paediatric wards, is the best method for prevention of cardiac arrest. Training health care providers remains a real challenge, at least in hospitals in France.
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Chéron, G., Saint-Blanquat, L., Nouyrigat, V. et al. Prise en charge de l’arrêt cardiaque du nourrisson et de l’enfant. Ann. Fr. Med. Urgence 1, 403–407 (2011). https://doi.org/10.1007/s13341-011-0121-5
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DOI: https://doi.org/10.1007/s13341-011-0121-5