Critical Evaluation of a Targeted Point of Care ROTEM and Multiplate Guided Coagulation and Haemostasis Management Program in Severe Trauma and Critical Bleeding

Rapid assessment of impaired blood clotting in critically bleeding patients

Grant ID: EMSS-406R21-2014

Project Summary

In this project, the team investigated how to assess and treat patients with clotting disorders as a result of trauma and severe bleeding.

Patients with severe trauma and critical bleeding have a high risk of death from haemorrhage and the complications associated with large volume blood transfusion. The ability of the patient to form a blood clot will be assessed using a ROTEM/multiplate device. This device gives an in-depth assessment of the patient’s clotting and allows specific treatment to be targeted at specific clotting defects. Using this technology, the investigators hope to reduce the amount of bleeding in these cases and also reduce the amount of blood transfused to these patients. The project will implement a blood product transfusion program guided by the ROTEM/multiplate device.

---

Outcomes

The implementation of a targeted VHA (ROTEM®) guided coagulation management program in trauma patients resulted in significant increase in early fibrinogen supplementation and reduction of fresh frozen plasma usage. Larger studies are needed to further define the role of early VHA testing to guide correction of trauma-induced coagulopathy and the effect on clinical outcome

---

Leveraged Funds

- Gold Coast Health Private Practice Fund: $9000
- In-kind: $70,000

---

Dissemination

Campbell, D., Wake, E., Walters, K., Ho, D., Keijzers, G., Wullschleger, M. and Winearls, J., 2021. Implementation of point‐of‐care ROTEM® into a trauma major haemorrhage protocol: A before and after study. Emergency Medicine Australasia, 33(3), pp.457-464.

Conferences:
- Oral: 42nd Australian and New Zealand Annual Scientific Meeting Annual Scientific Meeting on Intensive Care, Gold Coast, October 2017
- Poster: GCUH Research Week 2017
- Oral: SWAN Trauma Conference, Sydney, July 2016
- Oral & poster: World Trauma Congress, New Delhi, India, August 2016
- Oral: WFCCN/ACCCN, April 2016
- Oral: ‘ROTEM in Trauma’, Royal College of Pathologies Australia, Pathology Update, February 2016
- Oral: TEM International Critical Bleeding Meeting. Bangkok, January 2016
- Oral & Poster: Gold Coast Health and Medical Research Conference, December 2015
- Oral: ‘Targeted Coagulation Management in Trauma’, Queensland Trauma Symposium, Brisbane, February 2015
- Poster: Gold Coast Nursing and Midwifery, September 2015
- Oral: ‘Application of ROTEM point of care testing in critical bleeding’ Argentina Society Haematological Conference, Buenos Aires, September 2015
- Oral & poster: ‘Targeted Coagulation Management’, Australian Trauma Society, Gold Coast, October 2015
- Oral: ‘Point of Care Testing- an intensive care perspective’, Haematology Association of Australia, Adelaide, October 2015
- Oral: ‘Use of ROTEM in Critically Bleeding Patients’, National Blood Symposium, Brisbane, 2015
- Oral: ‘Targeted Haemostasis in Critical Bleeding’, Bedside Critical Care Meeting, Cairns, October 2014

---

Video/Presentations

SHARE