The use of ‘viscoelastic tests’ in driving transfusion needs in major trauma patients

Abstract

Haemorrhage can be attributed to approximately 50% of the 5 million trauma deaths worldwide every year. The development of damage control resuscitation techniques and major haemorrhage protocols has revolutionized trauma resuscitation. In this review we aim to explore the phenomenon of acute traumatic coagulopathy, the history and development of ‘viscoelastic tests’, the theory behind their use, the basic nomenclature and the role of these tests within the clotting cascade. We also look at the assessment of acute traumatic coagulopathy and the role of viscoelastic tests within goal-directed trauma resuscitation. Of particular interest is a review of the current recommendations for the implementation of thromboelastic tests in major haemorrhage guidelines and protocols.