%0 Journal Article %A Kay Tai Choy %A Merve Hartslief %T Successful ROTEM-guided transfusion therapy in a case of rural paediatric trauma %D 2019 %R 10.1136/bcr-2019-229508 %J BMJ Case Reports %P e229508 %V 12 %N 7 %X Massive transfusion therapy in severe paediatric trauma is a challenge. When this occurs in a rural setting, the potential delays in accessing medical services can lead to worse coagulopathy on presentation. We report successful treatment of a child post-traumatic lower limb amputation where treatment was only initiated 3 hours postinjury due to difficulties in access/retrieval. Rotational thromboelastometry (ROTEM)-guided, goal-directed haemostatic therapy perioperatively utilising a blood product ratio of 2:2:1 units of red blood cell:free frozen plasma:platelet reverted his coagulopathy. This report aims to raise awareness of the utility of ROTEM in paediatric trauma. %U https://casereports.bmj.com/content/bmjcr/12/7/e229508.full.pdf