Journal of Emergencies, Trauma, and Shock
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Year : 2018  |  Volume : 11  |  Issue : 4  |  Page : 265-270

World Academic Council of Emergency Medicine experience document: Implementation of point-of-care thromboelastography at an academic emergency and trauma center

1 Department of Anesthesia and Trauma Surgery, Hamad General Hospital, Doha, Qatar
2 Department of Surgery, Trauma and Vascular Surgery, Clinical Research, Hamad General Hospital; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
3 Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
4 Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar

Correspondence Address:
Dr. Ayman El-Menyar
Department of Surgery, Trauma and Vascular Surgery, Clinical Research, Hamad General Hospital, Doha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_134_17

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Background: We aimed to discuss the initial experience of the implementation of point-of-care thromboelastography (POC-TEG) at the Level 1 Trauma Center of an academic health institution in Qatar. Materials and Methods: A TEG protocol was developed and tailored to our hospital requirements and patient population, after an exhausting review of the literature and international published protocols, including a synthesis of a preexisting TEG protocol from our heart hospital. To successfully achieve the incorporation of point-of-care testing (POCT) in our clinical practice, a multidisciplinary organizational and education approach is required. The education and training of the physicians in this POCT modality during the first 3 months period has been described in detail. Results: A TEG protocol has been developed and implemented according to hospital standards. Ten physicians from the department of trauma surgery have been trained over a 3-month period to perform the daily quality control as well as the patient samples in order to provide a 24/7 service. In patients with major trauma, brain injury, bleeding, sepsis, and coagulopathy are the most important determinants of the clinical course and outcomes. Viscoelastic whole-blood assays have already proved their values in cardiac as well as liver surgery. Therefore, this POCT-directed approach would be considered as a part of the goal-directed management in severe polytrauma patients. Conclusions: Our experience shows that implementation of POC-TEG program is feasible and it is a promising tool in the management of major trauma patients with a potential compromised coagulation. However, further prospective research projects and well-trained personnel still warranted.

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