cath hurn: teg/rotem in the real world
DESCRIPTION
Hurn talks us through thrombelastography on the front line.TRANSCRIPT
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TEG in the real world
Know your weapons
Catherine Hurn SMACC 2013
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3-4 points take away…
Some new vocabulary
As for TEGwhat it doeswhat it might doand what it doesn’t do
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Vocabulary
ATC
ACoTS
TICTEG
ROTEM
ETIC
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Vocabulary
ATC
ACoTS
TIC
ETIC
Acute traumatic coagulopathy
Trauma induced coagulopthy
Early trauma induced….
Acute coagulopathy of traumatic shock
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Coagulopathy definition
1.5 times normal
INR 1.5, aPTT 60
INR 1.2
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Brohi 2010
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Maybe we just need another test…
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Potential roles for TEG
1. Early diagnosis of coagulopathy2. Indicator of prognosis3. Guiding blood transfusion
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1. Early diagnosis of coagulopathyATC characterized by reduced clot strength
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2. Indicator of patient outcomes3 x more likely to receive transfusion70% required a MT
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3. Guiding blood transfusion
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Fig 1 Algorithm for goal-directed massive transfusion. The transfusion algorithm relies on thrombelastography (TEG) tracing variables to direct blood component therapy. <ce:italic> r-TEG,</ce:italic> Rapid TEG; <ce:italic> ACT,</ce:italic> acti...
Michael Pezold , Ernest E. Moore , Max Wohlauer , Angela Sauaia , Eduardo Gonzalez , Anirban Banerjee , Christophe...
Viscoelastic clot strength predicts coagulation-related mortality within 15 minutes
Surgery Volume 151, Issue 1 2012 48 - 54
http://dx.doi.org/10.1016/j.surg.2011.06.023
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rTEG trace
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Potential roles for TEG
1. Early diagnosis of coagulopathy2. Revealing patient prognosis3. Guiding blood transfusion4. Assess Dabigatran5. Assess risk for PE
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In the real world…
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ISSUES
TrickySmall cohortDud test results
Really POC?
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