ROTEM – Real cases discussed

These cases are all real de-identified cases shared by many and written up over the last 3-4 years for the purposes of demonstrating the use of ROTEM guided therapy in action. They are very useful for reinforcing the principles but you should also consider completing the 3 module ROTEM learning package to ensure you understand the underlying principles:

ROTEM Learning package

To get the most educational benefit from reading these cases – you need to try and interprete them yourself before reading the discussion. Open the following link below in a new tab so that you can refer to a ROTEM algorithm as you read through them:

ROTEM algorithms for reference August 2018


Case 1 – Code Blue Caesarean at Midnight – ruptured uterus

Case 2 – Placenta percreta a challenging case

Case 3 – Elective Open AAA repair

Case 4 – Unexpected massive haemorrhage in a peripheral clinic

Case 5 – Upper GI haemorrhage

Case 6 – Abruption and fetal death in utero

Case 7 – Major cancer resection and bleeding after a termination

Case 8 – Bleeding after non elective CS how long does it take to correct the fibrinogen

Case 9 – Placenta percreta massive blood loss case number 2

Case 10 – Uterine inversion

Case 11 – Abruption and severe coagulopathy

Case 12 – Shark attack and lower limb blood loss

Case 13 – Bleeding ectopic pregnancy

Case 14 – Uterine atony then severe unexpected coagulopathy

Case 15 – Uterine atony and 1.7litre blood loss

Case 16 – Postpartum haemorrhage make sure you give enough fibrinogen

Case 17 – Major burns debridement

Case 18 – Unexpected accreta and panic

Case 19 – Bleeding after caesarean is that fibrinolysis

Case 20 – Anaphylaxis under GA and now they are oozy

Case 21 – Amniotic fluid embolism and now she is oozy

Case 22 – July 2018 Post CABG fibrinolysis

Case 23 – August 2018 Abruption and Fetal Death

Case 24 – Sept 2018 MVA Fibrinolysis and low fibrinogen






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