Dealing with Trauma Coagulopathy on Deployment

Coagulopathy in trauma patients is common. This problem has been shown to be higher in
military casualties than civilian and is associated with a 5-fold increase in mortality. Survival has been improved with the development of damage control resuscitation where patients receive both blood and blood products to rapidly and proactively treat the clotting problem. Standard laboratory tests offer little in the haemostatic resuscitation that occurs in the treatment of battlefield patients who receive massive transfusions. Thromboelastometry (TEM) is one technique that can offer rapid, near-patient testing of the coagulation status. This paper describes the introduction of this technique into the UK Role 3 Medical Facility in Helmand Province, Afghanistan.