EXTEM
Total clot
Clot builds, but final firmness is reduced
- CT
- not the dominant problem
- A5
- reduced
- MCF
- reduced
ICU hemostasis
TEG / ROTEM Lab
Learn to move from trace shape to a clinical phenotype, then to a targeted and locally validated action. The schematics are teaching aids—not patient results or universal transfusion thresholds.
Paired-channel interpretation
TEG / ROTEM Bedside Lab
Read the two channels together: identify the dominant phenotype, confirm it in the patient, and avoid treating a trace in isolation.
Worked interpretation
Low fibrin-based firmness during major bleeding
A bleeding trauma or obstetric patient has weak FIBTEM firmness relative to the total-clot channel.
Teaching readout
FIBTEM
Fibrin contribution
Fibrin-based firmness is disproportionately low
- A5
- markedly reduced
- A10
- markedly reduced
- MCF
- low
Dominant phenotype
A fibrinogen deficit or impaired fibrin polymerisation is a leading phenotype—not a diagnosis by itself.
Confirm before acting
Check clinical bleeding, Clauss fibrinogen and the local FIBTEM/functional-fibrinogen algorithm; correct calcium, temperature and major dilution at the same time.
Do not conclude
Do not give platelets alone or copy a cryoprecipitate/fibrinogen dose from another device protocol.
60-second reading order: confirm clinically important bleeding and source control → check initiation → compare early firmness (A5/A10 where used locally) → compare total and fibrin-specific channels → check lysis or heparinase comparison → intervene through the local pathway and repeat the clinical/trace assessment.
| TEG | ROTEM | Teaching interpretation |
|---|---|---|
| TEG R-time | ROTEM CT | Initiation: factor deficiency, anticoagulant effect, dilution or pre-analytic problems are possible contributors. |
| TEG K / alpha angle | ROTEM CFT / alpha angle | Propagation: use with fibrinogen assessment and local reagent-specific ranges. |
| TEG MA | ROTEM MCF | Maximum firmness: combines platelet and fibrin contributions. |
| TEG LY30 | ROTEM ML / CLI | Lysis: timing and cut-offs differ by analyser and protocol. |
Trace shapes, labels and readouts are teaching schematics and not a universal trigger. Numeric reference intervals, assay availability and treatment triggers depend on the instrument, reagent, patient population and local validated algorithm.