A point of care blood analyser which played a vital role managing major bleeding (coagulopathy) in injured soldiers on the front line in Afghanistan has now been recommended by the National Institution for Health and Care Excellence (NICE) for use within the NHS in England and Wales. ROTEM® is recommended to be used to detect the cause of major bleeding in cardiac surgery.1
NICE recommends that ROTEM® should replace all or some of the standard laboratory testing (if the laboratory testing does not provide any supplementary information). Typically when blood is sent to hospital laboratories for analysis, it can take up to an hour for test results to be returned, during which time potentially unnecessary blood transfusions have been given to the patient. Only once the tests are returned can result-driven treatment decisions be made.
ROTEM® is a point of care blood analyser so the blood tests are performed at the patient's side. From the moment the first test is run, doctors can start to see results with a full set of test completed within 10 minutes. This not only can improve the treatment decision-making process and a patient's recovery, but also conserves vital blood products. The use of ROTEM® has been shown to save a hospital Trust £344,183 from its cardiac surgery budget and £95,507 for liver transplantation.2
'"When we are faced with a patient with major bleeding in cardiac surgery the early identification and monitoring of the cause of the bleed is crucial," explains Dr Robert Kong, Consultant Anaesthetist at the Sussex Cardiac Centre, in Brighton, where they already use ROTEM®. "Having ROTEM® in theatre allows us to quickly assess a patient's coagulopathy and respond quickly to their critical care, saving time and not subjecting them to unnecessary blood transfusions whilst we wait for lab tests to come through."
NHS Scotland already recommends the use of ROTEM® for cardiac and liver transplantation and supports the use of it in other surgical areas such as trauma, vascular surgery and obstetrics.2 Within the UK-Defence Medical Services (UK-DMS) in ROTEM® is a well-recognised haemostasis management device due to its physical robustness and easy operability and its ability to rapidly and accurately assess the cause of bleeding in injured soldiers. A paper published by the UK-DMS military team in 2012 concluded that ROTEM® has revolutionised the UK-DMS approach to the diagnosis and management of coagulopathy caused by military trauma.3