{"id":4718,"date":"2017-10-11T09:46:03","date_gmt":"2017-10-11T07:46:03","guid":{"rendered":"https:\/\/guillermou-avocats.fr\/?p=4718"},"modified":"2018-01-18T17:07:18","modified_gmt":"2018-01-18T16:07:18","slug":"id-143-syndrome-du-bebe-secoue-les-recommandations-2017-de-la-haute-autorite-de-sante","status":"publish","type":"post","link":"https:\/\/guillermou-avocats.fr\/fr\/actualites\/id-143-syndrome-du-bebe-secoue-les-recommandations-2017-de-la-haute-autorite-de-sante","title":{"rendered":"Syndrome du b\u00e9b\u00e9 secou\u00e9 : les recommandations 2017 de la Haute Autorit\u00e9 de Sant\u00e9"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\"  style='background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;'><div class=\"fusion-builder-row fusion-row \"><div  class=\"fusion-layout-column fusion_builder_column fusion_builder_column_1_1  fusion-one-full fusion-column-first fusion-column-last bigFontSize 1_1\"  style='margin-top:0px;margin-bottom:20px;'>\n\t\t\t\t\t<div class=\"fusion-column-wrapper\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;\"  data-bg-url=\"\">\n\t\t\t\t\t\t<div class=\"fusion-text\"><p>La Haute Autorit\u00e9 de sant\u00e9 (HAS), en collaboration avec la SOFMER, (Soci\u00e9t\u00e9 fran\u00e7aise de m\u00e9decine physique et de r\u00e9adaptation) a actualis\u00e9 le 29 septembre 2017 ses recommandations de bonne pratique concernant la pr\u00e9vention du syndrome du b\u00e9b\u00e9 secou\u00e9(SBS), la pr\u00e9c\u00e9dente recommandation de bonne pratique avait \u00e9t\u00e9 \u00e9tablie en mai 2011. Elles visent les professionnels des secteurs m\u00e9dico-sociaux et juridiques.<\/p>\n<p>Le syndrome du b\u00e9b\u00e9 secou\u00e9 (SBS) est difficile \u00e0 diagnostiquer. Il s\u2019agit de maltraitances sur l\u2019enfant : la personne ne supporte plus les cris du nourrisson et finit par la secouer pour le faire taire (une saisie manuelle du thorax du b\u00e9b\u00e9 sous les aisselles)\u2026 Le cerveau de l\u2019enfant va taper contre sa bo\u00eete cr\u00e2nienne, ce qui va provoquer une h\u00e9morragie et des l\u00e9sions c\u00e9r\u00e9brales. Le choc \u00e9quivaut \u00e0 un\u00a0<strong><a href=\"http:\/\/guillermou-avocats.fr\/traumatisme-cranien\">traumatisme cr\u00e2nien<\/a><\/strong>\u00a0grave de l\u2019enfant. Les cons\u00e9quences peuvent \u00eatre dramatiques avec des l\u00e9sions c\u00e9r\u00e9brales \u00e0 vie \u00e0 l\u2019origine de\u00a0<strong><a href=\"http:\/\/guillermou-avocats.fr\/dommage-corporel\/le-handicap-moteur\">handicaps<\/a><\/strong>\u00a0lourds, voire conduire \u00e0 la mort du b\u00e9b\u00e9.<\/p>\n<blockquote>\n<p>\n<em>Le syndrome du b\u00e9b\u00e9 secou\u00e9 appel\u00e9 aussi Traumatisme cr\u00e2nien non accidentel par secouement, concerne 200 victimes par an, en majorit\u00e9 des nourrissons de sexe masculin ayant moins de 6 mois\u2026<\/em><\/p>\n<\/blockquote>\n<p>Entre autres, la Haute Autorit\u00e9 de Sant\u00e9 rappelle les signes \u00e9vocateurs et cliniques du syndrome du b\u00e9b\u00e9 secou\u00e9 :<\/p>\n<blockquote>\n<p><em>\u00ab\u00a0Une atteinte neurologique grave peut \u00eatre \u00e9voqu\u00e9e d\u2019embl\u00e9e, associant \u00e0 des degr\u00e9s divers :<\/em><br \/>\n<em>\u2013 malaise grave : troubles aigus de la vigilance et de la conscience allant jusqu\u2019au coma ;<\/em><br \/>\n<em>\u2013 apn\u00e9es s\u00e9v\u00e8res voire arr\u00eat cardio-respiratoire ;<\/em><br \/>\n<em>\u2013 convulsions r\u00e9p\u00e9t\u00e9es, voire \u00e9tat de mal convulsif ;<\/em><br \/>\n<em>\u2013 signes d\u2019hypertension intracr\u00e2nienne aigu\u00eb (plafonnement du regard, vomissements) ;<\/em><br \/>\n<em>\u2013 hypotonie axiale, d\u00e9ficit moteur brutal ;<\/em><br \/>\n<em>Certains signes non sp\u00e9cifiques, pouvant \u00e9garer le diagnostic d\u2019atteinte neurologique, sont \u00e0 conna\u00eetre :<\/em><br \/>\n<em>\u2013 p\u00e2leur ;<\/em><br \/>\n<em>\u2013 troubles de l\u2019alimentation, mauvaises prises alimentaires (stagnation de la courbe de poids),<\/em><br \/>\n<em>vomissements sans fi\u00e8vre ni diarrh\u00e9e ;<\/em><br \/>\n<em>\u2013 troubles du sommeil ;<\/em><br \/>\n<em>\u2013 modifications du comportement : b\u00e9b\u00e9 douloureux, irritabilit\u00e9 et pleurs.<\/em><br \/>\n<em>Ces \u00e9l\u00e9ments, qui peuvent \u00e9garer le diagnostic, traduisent soit une hypertension intracr\u00e2nienne<\/em><br \/>\n<em>(vomissements sans fi\u00e8vre ni diarrh\u00e9e, pleurs accentu\u00e9s par le d\u00e9cubitus dorsal), soit une an\u00e9mie<\/em><br \/>\n<em>s\u00e9v\u00e8re.<\/em><br \/>\n<em>D\u00e9couvertes de l\u00e9sions d\u2019allure traumatique<\/em><br \/>\n<em>L\u00e9sions sentinelles :<\/em><br \/>\n<em>\u2013 constatation de l\u00e9sions cutan\u00e9es en particulier \u00e0 type d\u2019ecchymose ou d\u2019h\u00e9matome ;<\/em><br \/>\n<em>\u2013 constatation de l\u00e9sions de la sph\u00e8re ORL, notamment \u00e0 l\u2019int\u00e9rieur de la bouche ;<\/em><br \/>\n<em>\u2013 d\u00e9couverte de fractures chez un enfant non d\u00e9ambulant.\u00a0\u00bb<\/em><\/p>\n<\/blockquote>\n<p>Elle r\u00e9v\u00e8le en particulier que l\u2019existence d\u2019 h\u00e9matomes sous-duraux (HSD) et d\u2019h\u00e9morragies r\u00e9tiniennes (HR) ,sont caract\u00e9ristiques du SBS.<\/p>\n<p>L\u2019HAS pr\u00e9conise le scanner en urgence puis l\u2019IRM ainsi qu\u2019un examen du fond d\u2019\u0153il. Ces examens permettent de d\u00e9terminer la r\u00e9p\u00e9tition des secousses et am\u00e9liorent leur datation.<\/p>\n<p>La HAS indique :<\/p>\n<blockquote>\n<p>\n<em>\u00ab\u00a0Par ailleurs, il est rappel\u00e9 qu\u2019en cas de suspicion de syndrome de b\u00e9b\u00e9 secou\u00e9, l\u2019enfant doit \u00eatre consid\u00e9r\u00e9 comme un traumatis\u00e9 cr\u00e2nien grave. Il doit b\u00e9n\u00e9ficier d\u2019une hospitalisation en soins intensifs p\u00e9diatriques, avec avis neurochirurgical. (\u2026)<\/em><\/p>\n<p><em>Ne pas diagnostiquer cette maltraitance expose \u00e0 un risque majeur de r\u00e9cidive et \u00e0 des s\u00e9quelles s\u00e9v\u00e8res \u00e0 vie ou au d\u00e9c\u00e8s\u00a0\u00bb<\/em><\/p>\n<\/blockquote>\n<p>L\u2019HAS pr\u00e9conise un signalement par transmission au Procureur de la R\u00e9publique concernant la situation d\u2019un enfant en danger ou susceptible de l\u2019\u00eatre : une double proc\u00e9dure est d\u00e9clench\u00e9e. Une au civil pour prot\u00e9ger l\u2019enfant et une au p\u00e9nal. Sur le plan p\u00e9nal, l\u2019acte de secouer est toujours consid\u00e9r\u00e9 comme volontaire m\u00eame si la personne n\u2019avait pas l\u2019intention de faire du mal au b\u00e9b\u00e9.<\/p>\n<p>Pour les personnes reconnues coupables du SBS, les peines encourues vont de 5 ans d\u2019emprisonnement \u00e0 30 ans de r\u00e9clusion criminelle.<\/p>\n<p>Le plus important reste de pr\u00e9venir tout acte de violence envers un enfant.<\/p>\n<p>Pour cela, la HAS adresse un message de pr\u00e9vention \u00e0 destination des nouveaux parents et des gardiens de nourrissons:<\/p>\n<p>&nbsp;<\/p>\n<table width=\"565\">\n<tbody>\n<tr>\n<td>\u2192\u00a0Voici une information sur les pleurs des b\u00e9b\u00e9s et sur le syndrome du b\u00e9b\u00e9 secou\u00e9.1) UN B\u00c9B\u00c9, \u00c7A PLEURE ! UN BEBE PEUT PLEURER JUSQU\u2019\u00c0 2 HEURES PAR JOUR ET C\u2019EST NORMAL. Cela ne veut pas dire que vous vous occupez mal de votre enfant ou qu\u2019il est malade.<\/p>\n<p>2) LE SYNDROME DU B\u00c9B\u00c9 SECOU\u00c9, \u00c7A EXISTE ! Les pleurs d\u2019un b\u00e9b\u00e9 peuvent conduire certains adultes qui n\u2019en peuvent plus \u00e0 le secouer. C\u2019est le syndrome du b\u00e9b\u00e9 secou\u00e9.<\/p>\n<p>3) SECOUER UN B\u00c9B\u00c9 PEUT LE TUER OU LE RENDRE HANDICAPE POUR TOUTE LA VIE. \u2013 Secouer, c\u2019est bien plus grave qu\u2019une chute. \u2013 Secouer n\u2019a rien \u00e0 voir avec le jeu. Jouer avec un b\u00e9b\u00e9 ce n\u2019est pas le secouer ! Jouer avec un b\u00e9b\u00e9 est indispensable \u00e0 son d\u00e9veloppement.<\/p>\n<p>4) IL SUFFIT D\u2019UNE FOIS ! ET C\u2019EST POUR TOUTE LA VIE.<\/p>\n<p>5) Si votre enfant pleure, il vous faut v\u00e9rifier : \u2013 qu\u2019il n\u2019a pas faim ; \u2013 que sa couche n\u2019est pas sale ; \u2013 qu\u2019il n\u2019a pas de fi\u00e8vre, qu\u2019il n\u2019est pas trop couvert.<\/p>\n<p><strong>Si malgr\u00e9 tout, il continue \u00e0 pleurer ET QUE VOUS N\u2019EN POUVEZ PLUS \u2013 COUCHEZ-LE SUR LE DOS DANS SON LIT ET PARTEZ \u2013 appelez quelqu\u2019un de proche \u2013 SURTOUT NE LE SECOUEZ PAS !<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Pour en savoir plus:<\/p>\n<p><a href=\"https:\/\/www.has-sante.fr\/portail\/jcms\/fc_1249693\/fr\/piliers\" target=\"_blank\" rel=\"noopener\">https:\/\/www.has-sante.fr\/portail\/jcms\/fc_1249693\/fr\/piliers<\/a><\/p>\n<p><a href=\"https:\/\/www.has-sante.fr\/portail\/upload\/docs\/application\/pdf\/2017-09\/reco239_recommandations_syndrome_bebe_secoue.pdf\" target=\"_blank\" rel=\"noopener\">https:\/\/www.has-sante.fr\/portail\/upload\/docs\/application\/pdf\/2017-09\/reco239_recommandations_syndrome_bebe_secoue.pdf<\/a><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div>\n\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[93],"tags":[],"class_list":["post-4718","post","type-post","status-publish","format-standard","hentry","category-actualites"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v23.4 (Yoast SEO v27.6) - 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