{"id":12431,"date":"2024-05-13T09:52:00","date_gmt":"2024-05-13T13:52:00","guid":{"rendered":"https:\/\/transfusionontario.org\/mise-en-oeuvre-de-protocoles-en-cas-dhemorragie-massive-dans-de-petits-hopitaux-defis-solutions-eventuelles-et-possibilites\/"},"modified":"2024-07-19T09:27:43","modified_gmt":"2024-07-19T13:27:43","slug":"mise-en-oeuvre-de-protocoles-en-cas-dhemorragie-massive-dans-de-petits-hopitaux-defis-solutions-eventuelles-et-possibilites","status":"publish","type":"post","link":"https:\/\/transfusionontario.org\/fr\/mise-en-oeuvre-de-protocoles-en-cas-dhemorragie-massive-dans-de-petits-hopitaux-defis-solutions-eventuelles-et-possibilites\/","title":{"rendered":"Mise en \u0153uvre de protocoles en cas d\u2019h\u00e9morragie massive dans de petits h\u00f4pitaux : d\u00e9fis, solutions \u00e9ventuelles et possibilit\u00e9s"},"content":{"rendered":"\n

Talal Mahdi, MD, FRCPC H\u00e9matopathologiste, Association des laboratoires r\u00e9gionaux de l\u2019Est de l\u2019Ontario, L\u2019H\u00f4pital d\u2019Ottawa <\/em><\/p>\n\n

Les protocoles en cas d\u2019h\u00e9morragie massive (PHM) sont des outils essentiels con\u00e7us pour acc\u00e9l\u00e9rer l\u2019administration de composants sanguins dans des situations urgentes en fonction des meilleures pratiques de gestion de patients en h\u00e9morragie. Ces meilleures pratiques comprennent l\u2019identification pr\u00e9coce des patients en cause, l\u2019administration rapide de composants et de produits sanguins ainsi que la r\u00e9ponse harmonis\u00e9e des ressources humaines pour identifier et contr\u00f4ler rapidement l\u2019h\u00e9morragie. <\/p>\n\n

M\u00eame si tout h\u00f4pital dot\u00e9 d\u2019une urgence, d\u2019un bloc op\u00e9ratoire ou de services obst\u00e9triques devrait avoir un PHM, la mise en \u0153uvre de ces protocoles peut s\u2019accompagner de probl\u00e8mes. Pensons notamment \u00e0 l\u2019engagement et \u00e0 la formation des partenaires en clinique, au manque de personnel, aux stocks limit\u00e9s de composants et produits sanguins, \u00e0 l\u2019\u00e9ventail limit\u00e9 d\u2019\u00e9preuves de laboratoire offertes et \u00e0 la capacit\u00e9 ou plut\u00f4t \u00e0 l\u2019incapacit\u00e9 d\u2019offrir un contr\u00f4le d\u00e9finitif de l\u2019h\u00e9morragie. Parmi tous ces obstacles, il existe toutefois des solutions qui pourraient optimiser la mise en \u0153uvre et l\u2019efficacit\u00e9 des PHM, pour finalement, am\u00e9liorer les soins dispens\u00e9s aux patients. <\/p>\n\n

L\u2019obstacle le plus important \u00e0 la mise en \u0153uvre d\u2019un PHM efficace dans de petits \u00e9tablissements est probablement li\u00e9 \u00e0 l\u2019adh\u00e9sion et \u00e0 la formation des coll\u00e8gues sur le plancher. Il est essentiel que toutes les personnes impliqu\u00e9es soient motiv\u00e9es tout au long du processus et form\u00e9es pour \u00eatre sur la m\u00eame longueur d\u2019onde, car le PHM exige une r\u00e9ponse coordonn\u00e9e et rapide de toute l\u2019\u00e9quipe. On peut y arriver en formant des sous-comit\u00e9s sp\u00e9cialis\u00e9s et en organisant des s\u00e9ances r\u00e9guli\u00e8res de formation ou d\u2019\u00e9valuation pour toutes les personnes susceptibles de participer \u00e0 la mise en \u0153uvre de ce protocole. <\/p>\n\n

L\u2019efficacit\u00e9 du PHM repose sur l\u2019identification rapide des patients en h\u00e9morragie massive et l\u2019administration rapide des composants ou produits sanguins n\u00e9cessaires. Le manque de personnel peut toutefois nuire grandement \u00e0 ce processus. En r\u00e9action \u00e0 ce probl\u00e8me, les h\u00f4pitaux peuvent mettre en place des proc\u00e9dures et politiques de travail apr\u00e8s les heures habituelles. En donnant au personnel m\u00e9dical et infirmier la possibilit\u00e9 d\u2019acc\u00e9der \u00e0 des unit\u00e9s de sang hors des heures r\u00e9guli\u00e8res en pr\u00e9sentant la documentation pertinente, les h\u00f4pitaux peuvent renforcer leur capacit\u00e9 \u00e0 r\u00e9agir rapidement aux h\u00e9morragies. <\/p>\n\n

En outre, en adaptant les analyses de sang aux ressources accessibles apr\u00e8s les heures, on peut simplifier davantage la proc\u00e9dure. Le recours \u00e0 des instruments au point de service permet de faire des analyses efficaces et de prendre rapidement des d\u00e9cisions au sujet des composants sanguins \u00e0 fournir. <\/p>\n\n

S\u2019il faut transf\u00e9rer le patient, il est possible de se pr\u00e9parer proactivement \u00e0 cette \u00e9ventualit\u00e9 en \u00e9tablissant des crit\u00e8res pr\u00e9cis d\u2019activation d\u2019un PHM. De plus, comme un PHM est rarement mis en branle dans la plupart des centres, des simulations r\u00e9guli\u00e8res d\u2019activit\u00e9s entourant ce protocole peuvent contribuer \u00e0 maintenir les comp\u00e9tences du personnel et \u00e0 garantir que les gens seront pr\u00eats \u00e0 ex\u00e9cuter efficacement le protocole quand le besoin s\u2019en fera sentir. <\/p>\n\n

L\u2019apprentissage r\u00e9trospectif est aussi utile; la mise en place de v\u00e9rifications r\u00e9guli\u00e8res fournit de pr\u00e9cieuses donn\u00e9es sur les activations ant\u00e9rieures du protocole, ce qui facilite le respect de la r\u00e9glementation et favorise l\u2019am\u00e9lioration continue de la qualit\u00e9. <\/p>\n\n

Enfin, lorsque les stocks de composants et produits sanguins sont in\u00e9vitablement limit\u00e9s, il importe de valoriser la communication et la collaboration avec les h\u00f4pitaux des environs. Cela peut aider en cas de p\u00e9nurie de composants ou de produits ou lors des transferts de patients et cr\u00e9er un r\u00e9seau d\u2019assistance en cas de besoin. <\/p>\n\n

M\u00eame si des d\u00e9fis li\u00e9s \u00e0 la mise en \u0153uvre d\u2019un PHM persistent, des mesures proactives et des strat\u00e9gies innovantes offrent des pistes pour surmonter ces obstacles. La mise \u00e0 profit de solutions \u00e9volutives, l\u2019entretien d\u2019un r\u00e9seau de soutien et d\u2019entraide ainsi que la promotion d\u2019une culture d\u2019am\u00e9lioration continue permettront aux h\u00f4pitaux de renforcer leur capacit\u00e9 de r\u00e9agir avec rapidit\u00e9 et efficacit\u00e9 aux cas d\u2019h\u00e9morragie massive, ce qui am\u00e9liorera les soins aux patients. <\/p>\n\n

Featured Resources<\/h2>\n\n

19th Annual TM Education Web Symposium<\/h3>\n
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Watch Archive<\/a><\/div>\n<\/div>\n\n
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Ontario’s MHP: Guidance for small\/remote hospitals<\/h3>\n
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\"\"<\/figure>\n<\/div>\n
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Hear from Dr. Jacob Pendergrast<\/a><\/div>\n<\/div>\n\n
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Implementation Checklist (MHP Toolkit) – Adult<\/h3>\n
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\"\"<\/figure>\n<\/div>\n
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Get it Now<\/a><\/div>\n<\/div>\n\n
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Patient Transport (MHP Toolkit)<\/h3>\n
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\"\"<\/figure>\n<\/div>\n
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Get it Now<\/a><\/div>\n<\/div>\n\n
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MHP Quality Metrics Portal<\/strong><\/h3>\n\n

Note:<\/strong> Each Ontario hospital will need to determine where the data for the metrics is housed within their facility and who will be responsible for gathering and entering the data.<\/em><\/p>\n

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\"Capture<\/figure>\n<\/div>\n

Upcoming Events<\/h2>\n\n

Transfusionists Talk<\/h3>\n
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\"\"<\/figure>\n<\/div>\n
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Register<\/a><\/div>\n<\/div>\n\n
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SCMT 2024<\/h2>\n
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\"\"<\/figure>\n<\/div>\n
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Register<\/a><\/div>\n<\/div>\n\n
<\/div>\n\n

U of T<\/h3>\n
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\"\"<\/figure>\n<\/div>\n

June 20, 2024 @12pm-1pm<\/strong><\/p>\n\n

MLT Session \u2013 Interesting serology cases<\/p>\n\n

Subscribe<\/a> to U of T Transfusion Medicine Rounds mailing list to get registration details<\/p>\n","protected":false},"excerpt":{"rendered":"

Talal Mahdi, MD, FRCPC H\u00e9matopathologiste, Association des laboratoires r\u00e9gionaux de l\u2019Est de l\u2019Ontario, L\u2019H\u00f4pital d\u2019Ottawa Les protocoles en cas d\u2019h\u00e9morragie massive (PHM) sont des outils essentiels con\u00e7us pour acc\u00e9l\u00e9rer l\u2019administration […]<\/p>\n","protected":false},"author":16,"featured_media":11574,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_tec_requires_first_save":true,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"_EventAllDay":false,"_EventTimezone":"","_EventStartDate":"","_EventEndDate":"","_EventStartDateUTC":"","_EventEndDateUTC":"","_EventShowMap":false,"_EventShowMapLink":false,"_EventURL":"","_EventCost":"","_EventCostDescription":"","_EventCurrencySymbol":"","_EventCurrencyCode":"","_EventCurrencyPosition":"","_EventDateTimeSeparator":"","_EventTimeRangeSeparator":"","_EventOrganizerID":[],"_EventVenueID":[],"_OrganizerEmail":"","_OrganizerPhone":"","_OrganizerWebsite":"","_VenueAddress":"","_VenueCity":"","_VenueCountry":"","_VenueProvince":"","_VenueState":"","_VenueZip":"","_VenuePhone":"","_VenueURL":"","_VenueStateProvince":"","_VenueLat":"","_VenueLng":"","_VenueShowMap":false,"_VenueShowMapLink":false,"_tribe_blocks_recurrence_rules":"","_tribe_blocks_recurrence_description":"","_tribe_blocks_recurrence_exclusions":"","footnotes":""},"categories":[138],"tags":[],"class_list":["post-12431","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bulletin"],"acf":{"attachment":null,"attachment_name":"","under_revision":"false","revised_date":null},"_links":{"self":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/posts\/12431","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/comments?post=12431"}],"version-history":[{"count":0,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/posts\/12431\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/media\/11574"}],"wp:attachment":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/media?parent=12431"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/categories?post=12431"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/tags?post=12431"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}