Recovery position significantly associated with a reduced admission rate of children with loss of consciousness

Arch Dis Child. 2016 Jun;101(6):521-526. doi: 10.1136/archdischild-2015-308857. Epub 2016 Jan 25.

Abstract

Background: Loss of consciousness (LOC) is often seen in children. The response of caregivers to a child with LOC has been poorly investigated. Potential caregivers (parents, teachers) seem to have a poor knowledge of the recovery position (RP)-that is, the position into which an unconscious child should be placed in order to protect the airway.

Objectives: To report the management and diagnoses of LOC in childhood, and to evaluate variables associated with an increased hospital admission rate.

Methods: We conducted a prospective cohort study of consecutive children aged between 0 and 18 years diagnosed with LOC at 11 paediatric emergency departments (PEDs) of 6 European countries. The enrolment period was 3 months. Data were obtained from parental interviews, PED reports and clinical examination.

Results: 553 children were enrolled. The most frequent final diagnoses causing LOC were seizures (n=278, 50.3%), and vasovagal syncope (n=124, 22.4%). Caregivers put the child in the RP in 145 cases (26.2%). The RP was independently associated with a significant decrease in the admission rate (aOR=0.28; 95% CI 0.17 to 0.48; p<0.0001).

Conclusions: Our study demonstrates for the first time that the RP may reduce the admission rate of infants with LOC. Caregivers often perform inadequate manoeuvres when a child becomes unconscious. Campaigns aiming at increasing knowledge of the RP should be promoted.

Keywords: Accident & Emergency; Comm Child Health.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Airway Obstruction / prevention & control
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / statistics & numerical data
  • Europe
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Patient Admission / statistics & numerical data
  • Patient Positioning / statistics & numerical data*
  • Patient Readmission / statistics & numerical data*
  • Prospective Studies
  • Seizures / complications
  • Syncope, Vasovagal / complications
  • Unconsciousness / etiology
  • Unconsciousness / therapy*