TEG, Trauma TEG
Kaolin TEG and Functional Fibrinogen (R, K, Angle, MA, LY30, FF-MA, FFLEV)
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.
Do not use a needle smaller than a 21 gauge for collection. Obtain appropriate volume of blood in first tube labeled DISCARD. Obtain full tubes for sample specimens. It is best to store tubes by laying them on their side, instead of standing them in a rack. Deliver to lab immediately. Sample must arrive in lab within 15 minutes of collection. Cannot be shared with other coagulation tests. Do not centrifuge sample. Keep sample at room temperature.