Sampling methods to the statistical control of the production of blood components.

The control of blood components specifications is a requirement generalized in Europe by the European Commission Directives and in the US by the AABB standards. The use of a statistical process control methodology is recommended in the related literature, including the EDQM guideline. The control reliability is dependent of the sampling. However, a correct sampling methodology seems not to be systematically applied. Commonly, the sampling is intended to comply uniquely with the 1% specification to the produced blood components. Nevertheless, on a purely statistical viewpoint, this model could be argued not to be related to a consistent sampling technique. This could be a severe limitation to detect abnormal patterns and to assure that the production has a non-significant probability of producing nonconforming components. This article discusses what is happening in blood establishments. Three statistical methodologies are proposed: simple random sampling, sampling based on the proportion of a finite population, and sampling based on the inspection level. The empirical results demonstrate that these models are practicable in blood establishments contributing to the robustness of sampling and related statistical process control decisions for the purpose they are suggested for.

[The response of intensive care medicine in situations of multiple victims and catastrophe]. / A Resposta da Medicina Intensiva em Situações de Múltiplas Vítimas e Catástrofe.

There is a change in attitude regarding critical patients in situations of multiple victims and disasters in order to give the better treatment to the largest number of patients. Recent large-scale accidents, including terrorist attacks and biological warfare as the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2002/2003 and pandemic influenza have demonstrated the need for an adequate response from Intensive Care Medicine in those contexts. It is essential, according to risk analysis, organizing and planning the response of the Intensive Care Units in accordance with its strategy to increase the capacity of beds in intensive care. It is necessary a permanent preparation of the Intensive Care Units to face exceptional situations, giving focus to the training of professionals, triage and expansion of Intensive Care Units, emphasizing the role of intensivists in these cases.