PT  - JOURNAL ARTICLE
AU  - Kay Tai Choy
AU  - Merve Hartslief
TI  - Successful ROTEM-guided transfusion therapy in a case of rural paediatric trauma
AID  - 10.1136/bcr-2019-229508
DP  - 2019 Jul 01
TA  - BMJ Case Reports
PG  - e229508
VI  - 12
IP  - 7
4099  - http://casereports.bmj.com/content/12/7/e229508.short
4100  - http://casereports.bmj.com/content/12/7/e229508.full
SO  - BMJ Case Reports2019 Jul 01; 12
AB  - 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.