[Quality assurance program for blood products in an out-of-hospital medical care unit].
BACKGROUND
Transfusion of blood products is part of out-of-hospital medical activity. Despite rare use of transfusion and difficult environment, the rules of transfusion must be respected: follow up to detect blood products, security, and patient's information before and after transfusion, follow up of infectious and immunological consequences. However, the current law and usable documents were not conceived for out-of-hospital emergency care.


OBJECTIVE
To improve follow-up of blood product transfusion in out-of-hospital medical care (Smur).


METHODS
Quality assurance programme.


METHODS
a) Initial evaluation with a retrospective analysis based on the medical chart of patient for whom transfusion has been performed; b) corrective measures were proposed with creation of a specific document concerning transfusion and guidelines for blood product delivery in the out-of-hospital emergency care; c) evaluation of the impact of these correctives measures.


RESULTS
Less than one per cent of patients treated by our Smur needed transfusion, mainly during interhospital transfer. Patients were in a life-threatening situation in 50% of cases. Follow-up improved after implementation of the programme from 25 to 83% of transfused patient (p < 0.001). Despite limitation due to the small number of patients, other parameters also improved.


CONCLUSIONS
The use of specific guidelines and document improves the follow-up of transfusion in out-of-hospital medical care.
Templier
F
F
Samu 92, Smur Graches, service d'anesthésie et de réanimation chirurgicale, hôpital Raymond-Poincaré, 92380 Garches, France. francois.templier@samu.org
Chavanne
D
D
Lagron
P
P
Chauvin
M
M
Douge
G
G
Loubert
G
G
Fletcher
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000592:standards* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D065227:Transfusion Reaction