Level I or Level II trauma patients upon admit to ED or when in surgery and experiencing major bleeding. Thromboelastograph (TEG) is a global assessment of hemostasis and measures the ability of a whole blood sample to form a clot. The TEG assay measures the viscoelastic changes induced by clot formation and evaluates adequacy of coagulation factors and platelet function as well as the rate of formation of a clot, its strength, stability, retraction and lysis.
The four key parameters of the TEG tracing are: (1) R or reaction time to initial clot formation; (2) Angle or rate of clot formation, (3) MA (maximum amplitude) or maximum strength of clot, and (4) LY30 or percent clot lysis 30 minutes after the MA. The TEGTRMA panel also includes the Functional Fibrinogen assay (FF-MA and FFLEV), allowing an estimate of the patient’s fibrinogen level. Used in conjunction with established transfusion algorithms, results of the TEG parameters can help guide blood component therapy and assist with management of massive transfusions.