Thromboelastography is available for patients at risk, or in the process, of bleeding heavily.  The technologists (in hours) and trauma ODPs (out of hours) have been trained in using the ROTEM machine in theatre.  All they require is a blue-topped sample.  Most patients in ACCU do not require a ROTEM; check with the consultant first.

ROTEMs are usually run for 20 minutes.  If you need a longer run (to check for abnormal fibrinolysis), let the bedside nurse and tech/ODP know.  Note that the machine can only take one sample at a time, so an emergency in theatre might still ‘bump’ your test off.

Creatine Kinase

A high proportion of our patients suffer from rhabdomyolysis.  The biochemistry laboratory’s automated analysers cannot give a value for CK when it is above 22,000 units/L.  In many instances, the actual value is important in order to know whether it is rising or falling.  Bleep the Duty Biochemist on 1611 to kindly ask them to perform serial dilutions.