St. Mark's Hospital - February 12, 2017

The new thromboelastogram (TEG) device has been implemented in the blood bank. This device allows more comprehensive assessment of the etiology of coagulation abnormalities Thromboelastography assesses clotting function by plotting whole blood viscosity over time. It is an old technology that is finding renewed usefulness in patient care.

Two assays can be ordered in Epic: TEG Basic, and TEG Platelet Mapping. TEG has replaced the platelet function test previously available in the laboratory. TEG assays generate both graphical and numerical results, assessing the REACTION TIME for initial fibrin formation (clotting factors); “K” or “clot time” and ALPHA ANGLE, which measure the speed of clot formation (platelets, fibrinogen); and the “MA” or MAXIMUM AMPLITUDE, which reflects clot strength (platelet function, fibrin).

Use of these assays have particular clinical value in assessing patients with bleeding or clotting issues on oral anticoagulants for which assays are not available, coagulation in sepsis/DIC, during massive transfusion protocol, coming off bypass from cardiovascular surgery, in liver failure coagulopathy, etc. Graphical patterns aid in differentiating normal, factor deficiency, platelet blockers, fibrinolysis, hypercoagulable states, and stage 1 from stage 2 disseminated intravascular coagulation. TEG may also assist in deep vein thrombosis risk assessment.

The turnaround time from arrival in lab to result is ~20 minutes. Graphical and numerical results can be viewed on most hospital computers or hospital-issued portable devices by using a clinician-specific logon. Numerical results may be viewed in Epic. You may schedule training on assay interpretation and obtain a logon by calling Shelly Arnold at (701) 400-8012.

For assistance in interpreting TEG assays, you may call the TEG Helpline at (800) 438-2834 24/7 for guidance in interpretation.

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