During a paediatric traumatic cardiac arrest, is ventricular fibrillation a reversible cause like any other?

We congratulate the authors on their choice of methodology and on their algorithm for managing paediatric traumatic cardiac arrest (TCA).1 The algorithm specifies the management of TCA by prehospital emergency teams.

We would like to share our surprise at the experts' unanimity in favour of deprioritising defibrillation. Indeed, ventricular fibrillation should be considered as a reversible cause of circulatory arrest, like any other. In addition, the use of an external automated defibrillator may limit the rescue team's mental load while ensuring high device performance.2

We are concerned that confusion has appeared in experts' minds between the time required to analyse the heart's rhythm, which requires a task interruption lasting 10–12 s, and the time required for the actual defibrillation action, which only takes a few seconds.3

We would like to suggest that the first heart rhythm analysis be performed after the first two actions...

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