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Blood transfusion safety covers all stages from prescription of immuno-haematological examinations until the completion of the transfusion. According to the 05/11/2006 Afssaps' decision on good transfusion practices, transfusions should not be given at night unless the patient is actively bleeding or has some other urgent clinical need. A retrospective study was used to assess the proportion of transfusions at night. Through this professional practice evaluation, we analyze the reasons leading to perform transfusions at late hours, in order to reduce errors and improve safety for patients.

Blood transfusion safety covers all stages from prescription of immuno-haematological examinations until the completion of the transfusion. According to the 05/11/2006 Afssaps' decision on good transfusion practices, transfusions should not be given at night unless the patient is actively bleeding or has some other urgent clinical need. A retrospective study was used to assess the proportion of transfusions at night. Through this professional practice evaluation, we analyze the reasons leading to perform transfusions at late hours, in order to reduce errors and improve safety for patients.

Introduction Les transfusions de concentres de globules rouges homologues et leurs indications sont encadrees par des textes reglementaires elabores par l’Agence nationale de securite du medicament et des produits de sante (ANSM) et la Haute Autorite de sante (HAS). L’augmentation des besoins en produits sanguins et le contexte de tension de l’approvisionnement rendent indispensables d’harmoniser les pratiques transfusionnelles et par consequent de respecter les recommandations emises par les experts. Nous avons evalue la pertinence des prescriptions de CGR dans notre etablissement. Materiels et methodes Nous avons mene une etude prospective dans le but de confronter les donnees cliniques et biologiques ayant motive les transfusions aux recommandations emises par l’ANSM. Resultats Durant la periode etudiee, 155 prescriptions (soient 300 CGR) ont ete analysees. Les anemies aigues representaient le motif de prescription majoritaire (54,8 %) en regard des anemies chroniques (33 %) ou mixtes (8,4 %). Le motif restait inconnu dans 3,8 % des cas. Parmi les 18 prescriptions considerees comme non pertinentes a priori, 11 d’entre elles entraient dans le cadre des anemies chroniques et etaient emises en majorite par les services qui transfusaient le moins. Par ailleurs, si la moitie de ces transfusions etaient realisees pendant les periodes de garde, elles etaient pour 80 % d’entre elles prescrites en urgence relative. Conclusion Cette etude de pertinence des prescriptions de CGR permet d’evaluer la pratique des prescripteurs de CGR en regard des recommandations de l’ANSM. Elle constitue un etat des lieux permettant de cibler les actions correctives a mener. Il s’agit notamment de sensibiliser les prescripteurs par des seances de formation continue. Nous proposons egalement de mener une enquete relative aux connaissances des personnels medicaux et paramedicaux concernant les indications de tous les produits sanguins labiles.

The Unicel DXC 600 is an automated analytical system from Beckman Coulter for measuring usual biochemistry parameters (electrolytes, substrates and enzymatic activities), therapeutic drugs, drugs of abuse and specific proteins. According to the "Société française de biologie clinique (SFBC)" validation protocol, we tested the following parameters: electrolytes (sodium, potassium, chloride, total CO2), substrates (uric acid, calcium, phosphate, glucose, creatinine, urea, cholesterol, HDL cholesterol, bilirubin, iron, triglycerides), enzymes (ALAT, ASAT, amylase, CK, GGT, LDH, lipase, ALP), total proteins and specific proteins (albumin, CRP, haptoglobin). The results confirm the excellent analytical performances regarding imprecision. The comparison study shows differences between values obtained with Unicel DXC 600 and Integra 800 (Roche diagnostics), leading to the use of correcting factors for some parameters.

In this article, we report a case of metabolic coma with acidosis and elevated anion gap. The etiological investigation requires laboratory findings because clinical features are not enough specific in the early stage of intoxication. Measurement of methanol and formic acid, its toxic metabolite, is useful in confirming the diagnosis. The major differential diagnosis to discuss is ethylene glycol poisoning. Methanol poisoning is rare but potentially fatal; the toxicity of methanol is clearly correlated to the degree of metabolic acidosis. Formic acid accumulation is also associated with an increased risk for ocular and neurologic dysfunction. For preventing permanent visual damage, the acidosis should be corrected by antidotal treatment or haemodialysis in severe poisoning.