Thank you for joining me today to learn about how TEG6S can be utilized within #Anesthesiology. Let's recap on some of the topics that we learned such as specimen collection and transportation, test components, interpretations and more.
👇🏽Follow the #tweetorial below.
👇🏽Follow the #tweetorial below.
https://twitter.com/HermelinMD/status/1460801764517720067
First, we reviewed concepts of hemostasis.
Imagine that you cut your hand on a sharp piece of glass, ouch😲
After vasoconstriction, endothelial injury leads to PLT adhesion & aggregation --> the PLT plug.
Release of tissue factor activates coagulation cascade -->fibrin clot
Imagine that you cut your hand on a sharp piece of glass, ouch😲
After vasoconstriction, endothelial injury leads to PLT adhesion & aggregation --> the PLT plug.
Release of tissue factor activates coagulation cascade -->fibrin clot
Although we learn these pathways as if they happen sequentially, they are really happening simultaneously. 🔄Platelets are activated by thrombin formation, thrombin formation is activated by platelets.
⁉️What are the traditional coag labs?
⁉️What are the traditional coag labs?
🧪That's right. Traditional coagulation testing (PT/PTT) involves plasma based assays that only examine the coagulation factor portion of hemostasis. This doesn't always reflect the patient's TRUE clot or bleeding potential... 
👋🏽On the other hand, viscoelastic testing assesses BOTH the cellular + plasma coagulation factor interactions visualizing the ENTIRE clotting process from initiation to lysis. It's primarily used to personalize transfusion management and patient care.
I'm really excited that we have implemented @HaemoneticsCorp TEG6S within @SSMHealthSTL Core Lab area.
This analyzer, developed for point of care testing, is simple and automated and allows for 4 separate tests to be run at one time.
👇🏽Check out this clean & simple design below.
This analyzer, developed for point of care testing, is simple and automated and allows for 4 separate tests to be run at one time.
👇🏽Check out this clean & simple design below.
Remember that we have 3 cartridges to run 3 tests
☑️Global hemostasis
☑️Global hemostasis with lysis
✅Platelet Mapping
The samples should be collected using a 21 gauge needle, place tubes in the designated collection bag and send through the pneumatic tube system.
☑️Global hemostasis
☑️Global hemostasis with lysis
✅Platelet Mapping
The samples should be collected using a 21 gauge needle, place tubes in the designated collection bag and send through the pneumatic tube system.
🦶🏽Let's walk through the components of the cartridges...
R value is the time it takes initiate a clot and is measured in minutes.
When prolonged, this can be a sign of bleeding secondary to a factor deficiency and the need to transfuse FFP.
R value is the time it takes initiate a clot and is measured in minutes.
When prolonged, this can be a sign of bleeding secondary to a factor deficiency and the need to transfuse FFP.
Maximal Amplitude (MA), measured in mm, is the value that describes the clot strength at is maximum potential.
MA CRT: Clot strength with both platelets (80%) and fibrinogen (20%) contribution.
MA FF: Clot strength determined by fibrinogen contribution.
MA CRT: Clot strength with both platelets (80%) and fibrinogen (20%) contribution.
MA FF: Clot strength determined by fibrinogen contribution.
Lysis % 30 (LY30) describes the clot stability describing the fibrinolytic phase, or clot breakdown. If LY30 is increased then we have hyperfibrinolysis. This value is particularly important in the trauma setting when the goal is to STOP the bleed and from and maintain a clot.
To learn more about the topic of viscoelastic testing, I highly recommend reading this great article from @AABB 𝗧𝗿𝗮𝗻𝘀𝗳𝘂𝘀𝗶𝗼𝗻 Journal written by @TimCarll and Dr. Geoff Wool 👉🏽Basic principles of viscoelastic testing. onlinelibrary.wiley.com/doi/10.1111/tr…
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