NICE has assessed 3 viscoelastometric point-of-care testing devices (the ROTEM, TEG and Sonoclot systems), to help the NHS decide whether to use these products.

Viscoelastometric point-of-care testing may be useful to help determine if bleeding is because of a problem with the blood’s ability to clot, or because of a surgical bleed. This helps the doctor choose the right treatment to stop the bleeding. Using these systems may mean that patients are less likely to need a blood transfusion during surgery or need more operations to investigate further bleeding.

  • NICE has said that the ROTEM and TEG systems are recommended to help monitor blood clotting during and after heart surgery by healthcare professionals who have had appropriate training.

Because it’s not certain how much benefit they provide, NICE has said that:

  • the Sonoclot system should only be used in research to help monitor blood clotting during heart surgery
  • the ROTEM, TEG and Sonoclot systems should only be used in research to help monitor blood clotting in the emergency control of bleeding after an accident or after having a baby.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)