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Trauma Coagulopathy - what values?

Dr Timothy Hardcastle dr.tchardcastle at absamail.co.za
Wed Apr 15 07:00:45 BST 2009


Cat

This is a difficult one: There is a clinical coagulopathy unrelated to
specific numbers that is seen to occur with severe trauma. When the
initial bloods are drawn and the results come back the INR is >1,5, the
TEG is prolonged / abnormal - (often the first sign) and the platelets
progressively drop.

The problem is that the lab does the tests at 37'C, so any effect of
hypotermia is negated, thus giving values that may actually be more normal
than they truly are. The most important thing is a clinical ooze fromt he
patient's wounds.

Hope this helps

Tim
Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer University of KwaZulu-Natal Dept Surgery
Deputy Director - IALCH Trauma Service
Durban - South Africa
> Dear Traumalist
>
> What are the values for the current defintion of traumatic coagulopathy?
>
> At what values do you consider your trauma-patient coagulopathic, what
> INR, what platelet, what fibrinogen, what pH?
>
> Thanks, Cat
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