[Declarative survey about postpartum haemorrhage management by anaesthesiologists in Pays de la Loire area (France): what's the adherence to clinical practice guidelines?]. / Enquête déclarative sur la prise en charge anesthésique des hémorragies du post-partum dans la région Pays de la Loire: quelle adhésion aux recommandations pour la pratique clinique?

OBJECTIVE: To assess the management of postpartum hemorrhage (PPH) by anaesthesiologists in Pays de la Loire area. METHODS: A declarative survey was conducted from November 2011 to January 2012 with an online questionnaire to assess prevention and PPH specific care and to clarify the PPH transfusion practices and interest of new therapies. Nine indicators of adherence to clinical practice guidelines were selected to distinguish two groups: one group "adhering to the RCP" and another "not adhering to the RCP". RESULTS: Response rate 53%. One hundred and one responses were analyzed. Use of a collection bag graded blood receipt pockets 93%, start time of PPH noted: 76%, leaf specific monitoring: 67%, management of the third part of the work: 78%. The evacuation of the placenta is performed within 30minutes in 75% of cases. The transfusion strategy happens early (92% before the biological assessment results) and "aggressive" (ratio RCB/FFP is 1/1 for 72%). The use of tranexamic acid is not systematic (53%). Seventy-nine percent of respondents adhere to the RCP. Practitioners in maternity level 1 (with few deliveries) don't follow these RCP as much. CONCLUSION: Some inappropriate practices remain in structures not used to support them. The use of new therapies remain controversial. The priority at this time is the implementation and enforcement of the current RCP, not their modifications.

[Audit of the prehospital management of severe head injured patients in the "Pays-de-la-Loire" region]. / Evaluation de la régulation préhospitalière et prise en charge initiale des traumatisés crâniens graves dans la région des Pays-de-la-Loire Etude prospective, multicentrique.

OBJECTIVE: To study severe head injured patients (SHIP) during prehospital emergency care (Samu) and the first day in the French Pays-de-la-Loire area, in 2005. STUDY DESIGN: Prospective and multicenter. PATIENTS AND METHODS: All patients managed by Samu with GCS