- end of R to where clot reaches 20 mm - time to clot forming a fixed strength

6. Thromboelastography Flashcards by Kira Harms

TF function

converts F7 to F7a

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F7a function

converts F10 to F 10a

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F10a function

generates thrombin

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thrombin function

activates more plts and more factors to amplify clotting

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incr plt SA =

incr binding
incr clotting

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thrombin activates

plts
Factor 5
Factor 9

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thrombin convert

fibrinogen to fibrin to reinforce the clot

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tPA function

converts plasminogen to plasmin

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plasmin function

breaks clot apart

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thromboelastography

“recording the ability of a thrombus to change”

thrombus
ability to change
record

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what blood is used for TEG

whole blood

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what tube is needed for TEG

blue top

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how long TEG results

15-45 mins

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R time

time to beginning of start of clot formation

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normal R time

5-10 mins

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prolonged R time indicates

clotting factor deficiency

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prolonged R time treatment

FFP

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kinetics time

end of R to where clot reaches 20 mm
time to clot forming a fixed strength

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kinetics time normal

1-3 mins

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prolonged kinetics time

fibrinogen deficiency

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prolonged kinetics time treatment

cryo

alpha angle

speed of fibrin acculumlation
thrombin burst

alpha angle normal

53-72 deg

low alpha angle

fibrinogen deficiency

low alpha angle treatment

cryo

measure of strength of fully formed clot

normal MA

50-70 mm

decr MA

plt deficiency

decr MA treatment

plts DDAVP

LY30

% of fibrinolysis of clot after 30 mins

normal LY30

0-8%

high LY30

hyperfibrinolytic pt

high LY30 treatment

TXA

TEG pros

whole blood real-time results show prothrombosis

TEG does not indicate

uremia vW disease apsirin

TEG does not test

pt adhesion to tissue

what does TEG test

self-adhesion only

DIC

abnormal systemic blood clotting leading to organ failure concomitant consumtpion to plts and factors which lead to hemorrhagic complication

DIC S+S

excessive bleeding excessive clotting

excessive clotting features (3)

ARDS renal impairement CNS derangements

thresholds to treat PLTs

< 50,000

low PLT treat

1-2 units of PLTs

firbinogen threshold

< 1.5-2 g/L

low fibrinogen treatment

5-10 units cryo or 2 g fibrinogen concentrate

PT/PTT threshold

1.5x normal

high PT/PTT treatment

15-30 mL/kg FFP

should you treat bleeding in DIC

yes

what labs for possible DIC

clotting panel (blue top) TEG (blue top)

DIC labs

CBC clotting screen serum fibrinogen D-Dimer

DIC lab frequency

6-8 hrs

DIC treatment for lab evident DIC

LMWH

blood support order DIC

plt cryo/fibrinogen FFP