Traumacast EAST/AAST/AAST-AMC: SCC Review Series - Hematology II
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Apr 28, 2025 
In this engaging discussion, expert Dr. Martin Schreiber from the Uniformed Services University of the Health Sciences shares his insights on critical hematology topics. The conversation delves into the management of venous thromboembolism and anticoagulation strategies, shedding light on when to use IVC filters. They also discuss trauma-induced coagulopathy, the vital role of fibrinogen, and conditions like von Willebrand disease and sickle cell disease. Plasmapheresis applications in critical care and its significance in sepsis treatment round out this informative session.
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VTE Treatment Duration Advice
- Continue anticoagulation therapy for at least three months, then reevaluate the patient's risk profile.
- If long-term anticoagulation is refused, consider aspirin if no contraindications exist.
Pulmonary Embolism Management
- Treat stable patients with PE similarly to proximal DVT with anticoagulation.
- Consider systemic or catheter-directed TPA, embolectomy, or VA ECMO for hypotensive patients to stabilize and manage severe embolism.
NOACs Impact and PE Screening
- NOACs have revolutionized trauma VTE management due to ease of administration without monitoring, improving compliance.
- PE screening in trauma remains controversial, with no randomized trials clearly guiding practice.