Evaluation of hemoculture extraction technique in an emergency department: nursing staff self-perception and reality.

INTRODUCTION: Between 2009 and 2010, the rate of contamination of hemocultures drawn in our emergency department was much higher than the quality standards recommended, so we decided to check the extraction procedure of the samples to detect possible faults. We also wanted to study the perception of the nursing staff about the quality of their practice. METHODS: This is a prospective study developed in 2 phases. In the first phase, medical staff observed the extraction of hemocultures. In the second phase, an anonymous test was sent to the nursing staff of the emergency department. RESULTS: We observed major faults in the extraction procedure. Of the 10 items checked, only 2 had a compliance rate greater than 50%. There were significant differences between test answers and data recovered from observation in 7 items. DISCUSSION: Several technical deficiencies were observed in the procedure for extraction of blood cultures. This fact partly explains the high rate of contamination found in our emergency department.

Peripheral monocytes and neutrophils promote photoreceptor cell death in an experimental retinal detachment model.

Photoreceptor cell death and immune cell infiltration are two major events that contribute to retinal degeneration. However, the relationship between these two events has not been well delineated, primarily because of an inadequate understanding of the immunological processes involved in photoreceptor degeneration, especially that of peripheral leukocytes that infiltrate the subretinal space and retinal tissues. In this work, we characterized the role of leukocyte infiltration within the detached retina. We observed that CD45+ CD11b+ Ly6G+ neutrophils and CD45+ CD11b+ Ly6G- Ly6C+ monocytes are the predominant peripheral immune cell populations that infiltrate the retinal and subretinal space after detachment. Selective depletion of monocytes or neutrophils using cell-specific targeting is neuroprotective for photoreceptors. These results indicate that peripheral innate immune cells contribute to photoreceptor degeneration, and targeting these immune cell populations could be therapeutic during retinal detachment.