Sarah Morton1, Judi Galea1, James Uprichard2, Anthony Hudson1. 1. *St George's Hospital,Blackshaw Road,London,the United Kingdom. 2. †the Centre for Haemostasis and Thrombosis,St George's University Hospitals NHS Foundation Trust,London,the United Kingdom.
Abstract
OBJECTIVE: Trauma induced coagulopathy is a disorder of the coagulation pathway that occurs following major trauma. "Code red trauma" require massive hemorrhage protocol activation. The aim was to qualitatively establish the reasons TEG is not currently utilized and the ongoing practicalities in performing a TEG sample for trauma-related massive hemorrhage. METHODS: A pilot study was performed using a TEG6s machine within one central London Major Trauma Centre's resuscitation department. Staff were asked to run a TEG sample on any "code red" patient who attended during the trial. Staff were given questionnaires both before and after the trial to assess the knowledge around TEG. RESULTS: A TEG sample was performed in 75% of the sixteen "code red traumas," with one sample being unsuccessful. Only one patient had their blood component management altered due to the TEG result with only 50% of consultants and registrars surveyed feeling confident in interpreting TEG results. CONCLUSION: TEG6s samples can be run within the resuscitation department in a "code red trauma." However, there is a significant lack of knowledge relating to TEG within the emergency department which is likely to hinder its impact on personalized blood component management. More research is required in how to provide appropriate education in a busy setting to enable TEG to be utilized appropriately.
OBJECTIVE:Trauma induced coagulopathy is a disorder of the coagulation pathway that occurs following major trauma. "Code red trauma" require massive hemorrhage protocol activation. The aim was to qualitatively establish the reasons TEG is not currently utilized and the ongoing practicalities in performing a TEG sample for trauma-related massive hemorrhage. METHODS: A pilot study was performed using a TEG6s machine within one central London Major Trauma Centre's resuscitation department. Staff were asked to run a TEG sample on any "code red" patient who attended during the trial. Staff were given questionnaires both before and after the trial to assess the knowledge around TEG. RESULTS: A TEG sample was performed in 75% of the sixteen "code red traumas," with one sample being unsuccessful. Only one patient had their blood component management altered due to the TEG result with only 50% of consultants and registrars surveyed feeling confident in interpreting TEG results. CONCLUSION:TEG6s samples can be run within the resuscitation department in a "code red trauma." However, there is a significant lack of knowledge relating to TEG within the emergency department which is likely to hinder its impact on personalized blood component management. More research is required in how to provide appropriate education in a busy setting to enable TEG to be utilized appropriately.
Authors: Matthew D Neal; Ernest E Moore; Mark Walsh; Scott Thomas; Rachael A Callcut; Lucy Z Kornblith; Martin Schreiber; Akpofure Peter Ekeh; Adam J Singer; Lawrence Lottenberg; Michael Foreman; Susan Evans; Robert D Winfield; Michael D Goodman; Carl Freeman; David Milia; Noelle Saillant; Jan Hartmann; Hardean E Achneck Journal: J Trauma Acute Care Surg Date: 2020-02 Impact factor: 3.697
Authors: James H Lantry; Phillip Mason; Matthew G Logsdon; Connor M Bunch; Ethan E Peck; Ernest E Moore; Hunter B Moore; Matthew D Neal; Scott G Thomas; Rashid Z Khan; Laura Gillespie; Charles Florance; Josh Korzan; Fletcher R Preuss; Dan Mason; Tarek Saleh; Mathew K Marsee; Stefani Vande Lune; Qamarnisa Ayoub; Dietmar Fries; Mark M Walsh Journal: J Clin Med Date: 2022-01-12 Impact factor: 4.241