État des lieux sur l'organisation de la transfusion sanguine en urgence au sein des établissements de santé français participant à la prise en charge initiale des polytraumatisés

Abstract: Objective: To describe the organization of medical and transfusion services within the framework of hospital admission for multiple trauma. Study design: National survey in France. Material and methods: All French hospitals caring for multiple trauma patients were sent a questionnaire. Organization of the medical and transfusion services, and their related resources were evaluated. Results: Among 372 questionnaires sent, 116 replies were received from structures which care for 18 (1-500) multiple trauma patients each year. An orthopaedic and an abdominal surgery unit were widely available whereas a neurosurgeon was available in 21% of responding centers. A transfusion site was found in 43%, whereas others have either a deposit for distribution to specific patients (40%) or a small deposit to cover urgent situations (17%). Comparison with legal or expert based rules of adequate transfusion process disclosed a variable incidence of practice dysfunctions (2-49%) depending on the parameter assessed. Conclusion: The French organization of multiple trauma patients'' care and blood transfusion delivered for these patients is not homogenous. Dysfunctions were found in all types of hospitals. Recommendations describing good practice seem necessary to be built at the national level. [Copyright &y& Elsevier]