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Reminder of important clinical lesson
CASE REPORT
Successful ROTEM-guided transfusion therapy in a case of rural paediatric trauma
  1. Kay Tai Choy and
  2. Merve Hartslief
  1. Department of Surgery, Cairns Hospital, Cairns North, Queensland, Australia
  1. Correspondence to Dr Kay Tai Choy, kaytai.choy{at}health.qld.gov.au

Abstract

Massive transfusion therapy in severe paediatric trauma is a challenge. When this occurs in a rural setting, the potential delays in accessing medical services can lead to worse coagulopathy on presentation. We report successful treatment of a child post-traumatic lower limb amputation where treatment was only initiated 3 hours postinjury due to difficulties in access/retrieval. Rotational thromboelastometry (ROTEM)-guided, goal-directed haemostatic therapy perioperatively utilising a blood product ratio of 2:2:1 units of red blood cell:free frozen plasma:platelet reverted his coagulopathy. This report aims to raise awareness of the utility of ROTEM in paediatric trauma.

  • haematology (incl blood transfusion)
  • resuscitation
  • trauma

https://doi.org/10.1136/bcr-2019-229508

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    Footnotes

    • Contributors KTC was the on call doctor who was presented with this case. He drafted up this manuscript after obtaining consent and performing a literature review. MH was the senior surgeon involved and provided overall oversight over this project.

    • Funding The authors have notdeclared a specific grant for this research from any funding agencyin the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.