Towards a better readability of reference centers for unexpected infant death

2023-05-03 15:23:58

An instruction published in the Official Bulletin “Santé-protectionsociale-solidarité” dated April 28, 2023, recalls the need for coordinated work by actors in favor of unexpected infant death (MIN), around the major role of referral centers for unexpected infant death (CRMIN).

The Ministry of Health and Prevention recalls in this text that in France, each year, from 250 to 350 children under the age of one die of unexpected infant death, this number of deaths remaining stable since the 2000s in France, positioning our country as one of the states with a high rate of MIN at European level. In 2007, the release and implementation of 2007 recommendations of the High Authority for Health (HAS) on the management of NID have made it possible to structure the three essential stages of these courses:
– pre-hospital care at the place of death, with the collection of initial data which includes in particular the circumstances of death as well as clinical and environmental data concerning the child and his family;
– hospital care in a specialized reference center (CRMIN), including an interview with the family, a complete clinical examination of the deceased child as well as a wide range of analyzes (biological, bacteriological, virological, metabolic, genetic, toxicological and possibly an autopsy;
– post-hospital care with regular monitoring of families.

In this journey, underlines the ministry, the role of the reference centers for unexpected infant death, 34 in number on the territory, and backed by hospitals, most often university centres, has proven to be decisive. It has two major advantages: the performance, by the specialized teams concerned, of the examinations recommended by the HAS and the reception and support of families.

Quels enjeux ?
- Un enjeu de meilleure lisibilité de l’offre des CRMIN ;
- Un enjeu de systématisation du transport des corps des enfants décédés vers les CRMIN ;
- Un enjeu d’articulation des acteurs autour des situations de MIN ;
- Un enjeu de renforcement de l’accompagnement psychologique des familles ;
- Un enjeu pour l’exhaustivité du recensement des MIN.

This instruction recalls the need for coordinated work by the actors in favor of these situations, around the major role of the CRMINs, and specifies the operating conditions of the latter, within the framework of attached “standard” specifications. It expects the ARS to disseminate these elements widely to professionals likely to intervene in the context of an MIN: hospital professionals, in particular emergency and emergency services, but also rescue services and liberal professionals likely to intervene on the site. of the death, it being specified that this dissemination will be relayed at the same time by a dispatch from the Ministry of Justice.

Official Bulletin Health Social Protection Solidarity N° 8 April 28, 2023, Instruction N° DGOS/R3/2023/44 of April 19, 2023 relating to the distribution of the specifications of the reference centers for unexpected infant death, page 212215.

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