Lab results screened live to theatres

Theatre teams can now see blood clotting results live on the big screen while they are being processed in the pathology lab.

This innovative way of working means theatre teams see the test results much faster which enables them to deliver individually-tailored care to patients without delay.

The new system also potentially reduces the use of blood products which improves patient safety, improves efficiency and reduces demand on vital resources.

When a patient is rushed into theatre suffering severe blood loss a blood sample is sent to the pathology lab at The James Cook University Hospital to be analysed on a TEG (Thromboelastograph) machine.

The TEG machine assesses how a patient’s blood is clotting to work out what type of blood product (platelets, fresh frozen plasma etc) they actually need.

This is good news for patients as blood product transfusions can impact on morbidity so the less blood that is transferred the lower the risk of any complications.

Thanks to assistance from the hospital’s IT team, the results can now be seen live on screens in the emergency theatres as they are processed so the most effective treatment can be given without delay.

Traditionally TEG machines are designed to be used by the doctor near to the patient but, as anaesthetist Elke Kothmann explains, this can take their attention away from the operating table for vital seconds.

“The idea is you are supposed to do the TEG test near to the patient so you can see the result developing,” she said. “But in reality it’s difficult to do the tests and if you don’t do it properly the results are useless. It’s a very skilled thing to do so we decided it was best carried out by experts in the pathology lab.

“Now if I have a bleeding patient in theatre I send a blood sample to the lab and they do the test extremely accurately and we can see the results via a live link in theatre so we instantly know what we need to do to treat the patient.

“This is great news for the patient as they get the full attention of the anaesthetist and the results are much quicker.

“Conventional clotting tests can take 45 minutes to get a blood result but now we have a much quicker turn around.

“It means we get all the benefits of near patient testing, but the test is done by a professional scientist in a quality controlled area. It’s like having a biomedical scientist in theatre with you!”

South Tees Hospitals NHS Foundation Trust currently has four TEG machines at James Cook bought with charitable funds from cardiothoracic services and regional haematology. Each machine cost around £10,000.

All four machines are now based in the pathology lab to maximise availability across the trust.

Daniella Winterburn trust haemostasis lead said: “We have around 30 biomedical scientists trained to do these tests. We offer a 24/7 service and all the governance, quality checks and maintenance.

“It’s been exciting to learn something new and this has really integrated pathology with the rest of the trust.”

Cardiothoracic anaesthetist Nick Stratford was the first to use one at the trust and teamed up with Dr Angela Wood, Daniella, Elke and Andy Roberts from IT to link the results live to theatres following a successful pilot scheme last year.

The test is mainly used for patients with severe bleeding, major trauma or heart problems.