Afflux massif de victimes pédiatriques

Any health crisis (epidemic, pandemic, terrorist acts, natural disasters or acts of war) must be anticipated by the implementation of a local, regional but also national plan adapted to children taking into account their vulnerabilities. The limited experience of the teams associated with a poor literature obliges us to extrapolate the concepts applied to adults and war medicine, whereas the anatomic and physiological particularities linked to age impose specific lesions and management strategies. The age-adjusted shock index (SIPA) can be a good indicator of the state of haemorrhagic shock as well as of the needs for transfusion, critical care admission, ventilation and mortality in traumatised children and could be useful for triage. The influx of paediatric victims remains an organisational, medical and human challenge. The optimisation of care is based on the pooling of knowledge and the involvement of the various players (paediatrician, emergency doctor, anaesthesiologist, intensivist and surgeon) in order to maintain the quality of care. It is important to homogenise the organisation and training by targeting multimodal communication, based on well-argued recommendations and innovative tools inspired by those used during the recent pandemic (the digital area). Simulation (procedural, human, digital, mass simulation) is a necessary and effective tool for the regular training of teams to deal with these exceptional situations.