Applications of viscoelastic hemostatic assays at the site of care: Considerations and implications

Abstract

Point-of-care (POC) coagulation testing is becoming increasingly utilized to ensure optimal patient care recognizing the diverse phenotypes of trauma-induced coagulopathy (TIC). Strict regulatory frameworks govern the certification and accreditation of laboratories using POC devices for the testing of human blood samples, and penalties are imposed for those not meeting compliance standards. The typically shorter turnaround time compared with standard coagulation tests allows rapid interventions which are particularly important in fast-paced clinical scenarios such as trauma care. While many see viscoelastic tests as a useful addition to standard coagulation tests, others have concluded that viscoelastic testing could replace conventional coagulation tests in hospitalized trauma patients altogether. Opportunities to bring viscoelastic testing into a prehospital setting are also being explored by research teams, with success reported using next-generation devices in ambulances and helicopter settings. Further research is ongoing to explore the full utility of viscoelastic devices in both the hospital and prehospital setting.