I had a very good question from one of our students, and I've reproduced it here for people to think about.....
The question was : should we expect a question on TEG or ROTEM in the exam?
"..studying smart - the important things that are likely to be on the exam..."
My answer was:
Personally I don’t think that TEG/ROTEM is a fair question, my reasoning being:
1. It is not a universal standard of care across EDs in Australia
2. It has not been incorporated into any definitive clinical guidelines
3. The interpretation is extremely subjective, and even centres that use it require an algorithm/flashcard for most consultants.
I don’t think the college could fairly ask a question about it, for example giving you a ROTEM trace and asking you to interpret it.
What I would be prepared to say about ROTEM is:
1. It exists
2. It can be used to definitively guide an MTP rather than just use a 1:1:1 ratio
3. The cons are it takes 10 minutes to run, and the interpretation can be variable
4. There is not definitive evidence to consider it standard of care.
I wouldn’t personally spend a huge amount of time reading further, as I don’t think it’s a really high yield topic. Again, studying smart - the important things that are likely to be on the exam - rather than everything ever written in a book - is important as you prepare.
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We work as emergency physicians, and teach, blog and write at resus.com.au