Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2001
[Quality assurance program for blood products in an out-of-hospital medical care unit].
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. ⋯ The use of specific guidelines and document improves the follow-up of transfusion in out-of-hospital medical care.
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Ann Fr Anesth Reanim · Oct 2001
Case Reports[Tetraplegia in the course of coma from drug intoxication].
It is reported a case of quadriplegia occurring in a 67-year-old women after she commits suicide with flunitrazepam. The patient stayed during around twenty hours unconscious, in the sitting position, with an extreme flexion of the neck on the left side. After injection of flumazenil the patient's consciousness was restored. ⋯ The fact that the patient suffered from cervicarthrosis would have already impaired the spinal blood flow regulation and consequently had probably damaged the spinal cord. No clinical improvement of the quadriplegia was noticed and the patient died in the intensive care unit thirteen days after admission. Such an exceptional complication after a toxic coma remind us the necessity to avoid long lasting vicious position of the cervical spine in anaesthesia and emergency practice.
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Ann Fr Anesth Reanim · Oct 2001
[Preoperative assessment of hemostasis in private clinics in Nord-Pas-de-Calais].
This study aimed at: i) stating what the routines are regarding ordering of preoperative coagulation test; ii) evaluating the impact on the use of pre-operative orders from the data obtained during the first and the second parts of the study. ⋯ In this study, repeated feed-back to the writers of the preoperative orders in the time interval between the two parts of the study did not induce a noticeable decrease in the number of preoperative coagulation tests ordered. The results show the necessity of a different approach to present scientific knowledge in order to modify medical behaviour.