Case 120 – Update 3!

Thank you for everyone’s ongoing input. Our patient is more haemodynamically stable but continues to have ongoing bleeding. She is now receiving group specific/compatible blood products. She has currently received:

  1. 6 units packed red cells.
  2. 6 units FFP
  3. 1g tranexamic acid with a further 1g TXA being infused

A repeat FBC / coagulation screen is in progress. Her latest TEG is below (dotted line is normal TEG for comparison).

TEG

R time: 8min (4-8min), K time: 5min (1-4min), a-angle: 30 (47-74), MA: 35 (55-73mm)

Questions:

  1. What blood products would you give based on the TEG?
  2. Based on the traditional FBC / coagulation screen what values would you be aiming for? e.g PT/APTT/fibrinogen/platelets greater than ?

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