About a month ago, a young woman by the name of Angela Knight reached out to let us to let us know that she believes the use of the thrombelastogram (TEG) saved her life. Â We were intrigued to say the least. Angela was preparing to give birth to her second son when she suddenly went into acute respiratory failure, a brief cardiac arrest, then subsequently progressed to DIC.
This all took place at Memorial Hospital in South Bend, Indiana – the home of Dr. Mark Walsh and Dr. Maury Hurwich. Dr. Walsh is no stranger to the Maryland CC Project and is a proud enthusiast of the TEG. Â Dr. Hurwich is an anesthesiologist at Memorial who has also played a major role in bringing the TEG to the bedside and incorporating it into hospital wide resuscitation protocols.
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Dr. Walsh’s suggested TEG based – goal directed blood component therapy based on work by Holcomb & Tapia.
So what do you think? Â Is the TEG ready for all forms of hemorrhagic shock & coagulopathy? Â Tell us your thoughts below!
Just so everyone knows, we do not have any disclosures with the TEG or any corporate ties. Â We do this for free. Â We love good medicine.
- Walsh M, Jbara M, et al. Thromboelastographic goal-directed blood component therapy for severe hemorrhage. Blood Bulletin. March, 2014.
- Jansen AJ, Van rhenen DJ, Steegers EA, Duvekot JJ. Postpartum hemorrhage and transfusion of blood and blood components. Obstet Gynecol Surv. 2005;60(10):663-71.
- Gist RS, Stafford IP, Leibowitz AB, Beilin Y. Amniotic fluid embolism. Anesth Analg. 2009;108(5):1599-602.
- Burtelow M, Riley E, Druzin M, Fontaine M, Viele M, Goodnough LT. How we treat: management of life-threatening primary postpartum hemorrhage with a standardized massive transfusion protocol. Transfusion. 2007;47(9):1564-72.
- Thachil J, Toh CH. Disseminated intravascular coagulation in obstetric disorders and its acute haematological management. Blood Rev. 2009;23(4):167-76.
- Tapia NM, Chang A, Norman M, et al. TEG-guided resuscitation is superior to standardized MTP resuscitation in massively transfused penetrating trauma patients. J Trauma Acute Care Surg. 2013;74(2):378-85.
- Holcomb JB, Minei KM, Scerbo ML, et al. Admission rapid thrombelastography can replace conventional coagulation tests in the emergency department: experience with 1974 consecutive trauma patients. Ann Surg. 2012;256(3):476-86.
