Critical Evaluation of a Targeted Point of Care (POC) ROTEM (Registered Trademark) and Multiplate (Registered Trademark) Guided Coagulation and Haemostasis Management Programme in Severe Trauma and Critical Bleeding

ROTEM / Multiplate targeted transfusion protocol. The primary aim is to validate the use of a Targeted Point of Care (POC) ROTEM (Registered Trademark) and Multiplate (Registered Trademark) Guided Coagulation and Haemostasis Management Programme in Trauma and Critically Bleeding patients. Trauma and critically bleeding patients undergoing treatment at the Gold Coast University Hospital will be managed according to a POC ROTEM and Multiplate targeted coagulation and haemostatic programme. Our programme has been established with rigorous quality assurance and quality control procedures in accordance with strict clinical governance guidelines. Treatment algorithms have been developed from normal reference ranges reported in the literature and from peer reviewed algorithms in the medical literature from experienced centres. Anthropometric measurements will be obtained at admission before collecting about 5 mL venous blood in sodium citrate tubes for analysis on ROTEM and Multiplate at baseline: - On arrival in the Emergency department in trauma patients - Recognition of significant bleeding - After initial baseline blood testing another venous blood sample will be collected 10 minutes post haemostatic intervention until haemorrhage control is achieved or as directed by treating clinician. ROTEM tests (EXTEM, INTEM, FIBTEM and APTEM) and Multiplate tests (ADP, ASPI, TRAP) will be performed according to manufacturer’s recommendations. Multiplate testing will be performed on all patients with an altered level of consciousness who are unable to provide a history and those patients currently taking anti-platelet agents. All other aspects of care will be as per standard GCUH Trauma Management Guidelines.