Changes in Coagulation in Standard Laboratory Tests and ROTEM in @entity130 XXXX Between On-Scene and Arrival in the Emergency Department.

@entity1 @entity2002 @entity341 @entity26 @entity1372 @entity1003 @entity3459 @entity880 @entity413 @entity130
BACKGROUND:: When @entity130 @entity1 arrive in the @entity341 ( @entity341 ), @entity1003 frequently is present. The time course, however, in which this @entity1003 develops is poorly understood. No study has fully evaluated the coagulation status, including thromboelastometry on-scene and at hospital arrival. We hypothesized that measured coagulation variables might change when measured at the scene of injury and upon arrival to the @entity341 . METHODS:: We performed a prospective, single-center, observational study investigating coagulation status in 50 @entity130 @entity1 on-scene and at arrival in the @entity341 . Measurements included arterial blood gases, ROTEM  , protein S100, protein C activity, protein S, Quick value, international normalized ratio, activated partial thromboplastin time, D-dimer, coagulation factor V (FV), coagulation factor XIII (FXIII), @entity2002 , hemoglobin, hematocrit, platelets, and volume and blood products being administered during the first 24 hours. RESULTS:: Significant changes between on-scene and the @entity341 were observed for the following values: partial venous @entity26 pressure increased and @entity1372 , @entity413 , and @entity880 decreased. For EXTEM, INTEM, and APTEM, clotting time and clot formation time increased significantly, whereas maximal clot firmness and angle a decreased significantly (all P  <= 0.004). For FIBTEM, clotting time increased significantly and maximal clot firmness decreased significantly. In the laboratory, significant reductions in hemoglobin, hematocrit, platelets, activated partial thromboplastin time, @entity2002 , FV, FXIII, protein C activity, protein S, and protein S100 were observed (all P  <= 0.001). CONCLUSIONS:: Although most all laboratory and rotational @entity3459 tests worsened over time when measured on-scene and in the @entity341 , monitoring coagulation at the scene of @entity130 does not provide clinically important information in a majority of @entity130 @entity1 . One hour after injury, significant activation and consumption of @entity2002 , FV, FXIII, protein C activity, and protein S were observed.
