{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:19:19Z","timestamp":1776835159799,"version":"3.51.2"},"reference-count":16,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,20]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Massive transfusion therapy in severe paediatric trauma is a challenge. When this occurs in a rural setting, the potential delays in accessing medical services can lead to worse coagulopathy on presentation. We report successful treatment of a child post-traumatic lower limb amputation where treatment was only initiated 3 hours postinjury due to difficulties in access\/retrieval. Rotational thromboelastometry (ROTEM)-guided, goal-directed haemostatic therapy perioperatively utilising a blood product ratio of 2:2:1 units of red blood cell:free frozen plasma:platelet reverted his coagulopathy. This report aims to raise awareness of the utility of ROTEM in paediatric trauma.<\/jats:p>","DOI":"10.1136\/bcr-2019-229508","type":"journal-article","created":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T11:45:57Z","timestamp":1564227957000},"page":"e229508","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Successful ROTEM-guided transfusion therapy in a case of rural paediatric trauma"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-5742","authenticated-orcid":false,"given":"Kay Tai","family":"Choy","sequence":"first","affiliation":[{"name":"Department of Surgery, Cairns Hospital, Cairns North, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merve","family":"Hartslief","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cairns Hospital, Cairns North, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,27]]},"reference":[{"key":"2025082722552636000_12.7.e229508.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.059808"},{"key":"2025082722552636000_12.7.e229508.2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-20-47"},{"key":"2025082722552636000_12.7.e229508.3","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13049-015-0097-z","article-title":"Transfusion therapy in paediatric trauma patients: a review of the literature","volume":"23","author":"Nystrup","year":"2015","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2025082722552636000_12.7.e229508.4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40560-016-0196-6","article-title":"Acute traumatic coagulopathy and trauma-induced coagulopathy: an overview","volume":"5","author":"Kushimoto","year":"2017","journal-title":"J Intensive Care"},{"key":"2025082722552636000_12.7.e229508.5","first-page":"638","article-title":"Acute traumatic coagulopathy","volume":"20","author":"Cap","year":"2014","journal-title":"Curr Opin Crit Care"},{"key":"2025082722552636000_12.7.e229508.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000075338.21177.EF"},{"key":"2025082722552636000_12.7.e229508.7","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181877a9c"},{"key":"2025082722552636000_12.7.e229508.8","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318265d267"},{"key":"2025082722552636000_12.7.e229508.9","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1111\/j.1460-9592.2004.01549.x","article-title":"Intraoperative pediatric blood transfusion therapy: a review of common issues. Part II: transfusion therapy, special considerations, and reduction of allogenic blood transfusions","volume":"15","author":"Barcelona","year":"2005","journal-title":"Paediatr Anaesth"},{"key":"2025082722552636000_12.7.e229508.10","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1056\/NEJMoa066240","article-title":"Transfusion Strategies for Patients in Pediatric Intensive Care Units","volume":"356","author":"Lacroix","year":"2007","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025082722552636000_12.7.e229508.11","doi-asserted-by":"publisher","DOI":"10.1186\/cc12685"},{"key":"2025082722552636000_12.7.e229508.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02319.x"},{"key":"2025082722552636000_12.7.e229508.13","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31822f1727"},{"key":"2025082722552636000_12.7.e229508.14","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1186\/cc13965","article-title":"Tranexamic acid in pediatric trauma: why not?","volume":"18","author":"Beno","year":"2014","journal-title":"Crit Care"},{"key":"2025082722552636000_12.7.e229508.15","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1265-x"},{"key":"2025082722552636000_12.7.e229508.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-012947","article-title":"Safety and efficacy of tranexamic acid in bleeding paediatric trauma patients: a systematic review protocol","volume":"6","author":"Urban","year":"2016","journal-title":"BMJ Open"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229508","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:55:32Z","timestamp":1756360532000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229508"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":16,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,27]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bcr-2019-229508"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229508","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}