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J Emerg Trauma Shock. 2018 Oct-Dec;11(4):265-270. doi: 10.4103/JETS.JETS_134_17.

World Academic Council of Emergency Medicine Experience Document: Implementation of Point-of-Care Thromboelastography at an Academic Emergency and Trauma Center.

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Department of Anesthesia and Trauma Surgery, Hamad General Hospital, Doha, Qatar.
Department of Surgery, Trauma and Vascular Surgery, Clinical Research, Hamad General Hospital, Doha, Qatar.
Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar.
Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar.



We aimed to discuss the initial experience of the implementation of point-of-care thromboelastography (POC-TEG) at the Level 1 Trauma Center of an academic health institution in Qatar.

Materials and Methods:

A TEG protocol was developed and tailored to our hospital requirements and patient population, after an exhausting review of the literature and international published protocols, including a synthesis of a preexisting TEG protocol from our heart hospital. To successfully achieve the incorporation of point-of-care testing (POCT) in our clinical practice, a multidisciplinary organizational and education approach is required. The education and training of the physicians in this POCT modality during the first 3 months period has been described in detail.


A TEG protocol has been developed and implemented according to hospital standards. Ten physicians from the department of trauma surgery have been trained over a 3-month period to perform the daily quality control as well as the patient samples in order to provide a 24/7 service. In patients with major trauma, brain injury, bleeding, sepsis, and coagulopathy are the most important determinants of the clinical course and outcomes. Viscoelastic whole-blood assays have already proved their values in cardiac as well as liver surgery. Therefore, this POCT-directed approach would be considered as a part of the goal-directed management in severe polytrauma patients.


Our experience shows that implementation of POC-TEG program is feasible and it is a promising tool in the management of major trauma patients with a potential compromised coagulation. However, further prospective research projects and well-trained personnel still warranted.


Bleeding; coagulopathy; point-of-care testing; rotational thromboelastography; thromboelastogram; trauma

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