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Education needed to correct improper care of unconscious infants

The recovery position, which protects the airway, may reduce the hospital admission rate of infants who had lost consciousness, and education campaigns aimed at correcting caregivers who perform the wrong maneuvers should be promoted, according to a study published in Archives of Disease in Childhood.

“Most parents have inadequate knowledge of first aid, and, more generally, the level of first-aid knowledge among caregivers is low,” Sebastien Julliand, MD, of the pediatric mobile service for emergencies and resuscitation, at the Robert Debré Hospital, Paris Diderot University, and colleagues wrote. “The recovery position is a lateral recumbent position of the body, into which an unconscious child must be placed as part of first-aid treatment.”

To study the potential effect of the recovery position on hospital admission rates among children with loss of consciousness, the researchers conducted a prospective cohort study. They examined cases of consecutive children aged between 0 and 18 years diagnosed with loss of consciousness at 11 pediatric EDs in six countries: Spain, France, Italy, Luxembourg, Belgium and Switzerland.

In all, 553 children were enrolled in the study over a period of 3 months, between July 1 and Sept. 30, 2014. The researchers obtained data through parental interviews, ED reports and clinical examination.

According to the researchers, the most frequent final diagnoses causing loss of consciousness were seizures, representing 50.3% of the 553 children, and vasovagal syncope, representing 22.4%. Caregivers put the child in the recovery position in 26.2% of cases. In addition, the recovery position was independently associated with a significant decrease in the admission rate (aOR=0.28; 95% CI, 0.17 to 0.48; P < 0.0001).

“In conclusion, our study showed that the [recovery position] may reduce the hospital admission rate of children with [loss of consciousness], but often is not performed,” Julliand and colleagues wrote. “Campaigns aimed at increasing the knowledge and skills of adults to deliver safe, effective first aid to children, and specifically those highlighting the importance of using the [recovery position], should be promoted.” – by Jason Laday

Disclosure: The authors report no relevant financial disclosures.