Hurn talks us through thrombelastography on the front line.

1. TEG
in the real world
Know your weapons
Catherine Hurn SMACC 2013

5. 3-4 points take away…
Some new vocabulary
As for TEG
what it does
what it might do
and what it doesn’t do

8. Vocabulary
ATC
ACoTS
TICTEG
ROTEM
ETIC

9. Vocabulary
ATC
ACoTS
TIC
ETIC
Acute traumatic coagulopathy
Trauma induced coagulopthy
Early trauma induced….
Acute coagulopathy of
traumatic shock

10. Coagulopathy
definition
1.5 times normal
INR 1.5, aPTT 60
INR 1.2

11. Brohi 2010

12. Maybe we just need another test…

23. Potential roles for
TEG
1. Early diagnosis of coagulopathy
2. Indicator of prognosis
3. Guiding blood transfusion

24. 1. Early diagnosis of
coagulopathy
ATC characterized by reduced
clot strength

28. 2. Indicator of
patient outcomes
3 x more likely to receive
transfusion
70% required a MT

29. 3. Guiding blood
transfusion

31. 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

33. rTEG trace

37. Potential roles for
TEG
1. Early diagnosis of coagulopathy
2. Revealing patient prognosis
3. Guiding blood transfusion
4. Assess Dabigatran
5. Assess risk for PE

38. In the real world…

40. ISSUES
Tricky
Small cohort
Dud test results
Really POC?