Laboratory:
Hematopathology
Referral Laboratory:
MiChart Code:
Rotem Testing, Initial
Soft Order Code:
ROTEM
Synonyms:
Extem Fibtem
Heptem
Container:
Blue top 3.2% sodium citrate Vacutainer® tube
Normal Volume:
Full 2.7ml blue top 3.2% sodium citrate Vacutainer® tube, venous draw only
Minimum Volume:
ROTEM Delta (Core Lab)-Full 1.8ml blue top 3.2% sodium citrate Vacutainer® tube, venous draw only ROTEM Sigma (POCT)- Full 2.7ml blue top 3.2% sodium citrate Vacutainer® tube
Special Handling:
Specimen must be kept at room temperature and delivered to the Hematology/Coagulation laboratory, Main Hospital, Room 2F471, along with the completed requisition, via walking directly to the lab of via the pneumatic tube system
Offsite Collection:
This test is available only to University of Michigan registered patients.
Onsite Collection (Michigan Medicine Hospitals Only):
  1. Collect venous blood in a Blue top 3.2%sodium citrate Vacutainer® tube. If the blood must be drawn through a VAD (vascular access device), the line should be flushed with 5 mL of saline and the first 5 mL of blood or six dead space volumes of the VAD discarded.
  2. Complete the requisition form available at https://www.medialab.com/dv/dl.aspx?d=1296813&dh=0f130&u=134848&uh=2cdf1 as follows:
  • Interpreting clinician name and ID/pager number
  • Check the test code
  • Check the specific desired test stop time in minutes
  • Fill out the main contact for pathology to call with questions
Hand deliver the sample at room temperature with the completed requisition to the Hematology/Coagulation lab on the 2nd floor Main Hospital, Rm# 2F360. [new line] Instruction for Phlebotomy Out Patient blood draw station:
  • When patient arrives with Rotem requisition from the physician, ONE click in MiChart will generate patient demographic label.
  • Soft order code – 1BLUE in soft Order Entry, and correct ordering physician from the requisition.
  • Draw 1 Blue top 3.2% sodium citrate Vacutainer® tube.
  • Write date and time of collection on the requisition.
  • Immediately Walk sample along with the requisition to Hematology/Coagulation lab on the 2nd floor Main Hospital, Rm# 2F471
Days Set Up:
Daily, 24 hours
Analytic Time:
Typically 30 minutes. Analytic time can be physician determined for individual cases.
Reference Range:
*Reference ranges may change over time. Please refer to the original patient report when evaluating results.
Interpretive report provided.
Test Usage:
Coagulation evaluations with the ROTEM® delta are commonly used to assess clinical conditions in organ transplantation, cardiovascular surgery, cardiology procedures and trauma to assess post-operative hemorrhage and/or thrombosis. Up to 4 ROTEM® tests can be selected on the requisition. If more than 4 tests are indicated, additional specimen will be required.
Contraindications:
ROTEM Delta (Core Lab) Arterial blood should not be used. Do not obtain blood from a heparinized access line, lock, or indwelling heparin lock.
Test Limitations:
  • ROTEM viscoelastic testing is not FDA approved for the pediatric population (<21 years of age) and the attached reference ranges pertain to adults only.
  • Patients with hypofibrinogenemia have not been fully evaluated. Dysfibrinogenemic patients were not tested.
  • Up to 4 ROTEM® tests can be selected on the requisition. If more than 4 tests are indicated, additional specimen will be required.
Test Methodology:
The Rotem system uses Thromboelastometric analysis to provide a quantitative and qualitative indication of the coagulation state of a blood sample that can detect clot formation and firmness as well as clot lysis.
Additional Information:
Physicians should complete Rotem result interpretation training in Cornerstone code PATH-62077 prior to ordering this test. Results are viewable as a scanned document in MiChart under Chart Review, Labs, Rotem Graphic Result. Result report will be loaded in Mi-Chart and can be viewed at Chart Review -> Labs -> ROTEM Graphic Result. [/list] To access GEMWebLive for remote viewing: [/list] 1. Use a Google Chrome or Microsoft Edge web browser to navigate to https://gem-web-live.med.umich.edu/ 2. Login using your unique name and level-2 password 3. Search for a patient by typing the patient's CSN into the Patient ID field If you are unable to login contact POCT by calling 66754 or emailing PATH-POC-INPATIENT@med.umich.edu.
Rejection Criteria:
Samples that are overfilled, underfilled, contain visible clots or debris, and are arterial blood will be rejected.
Storage Temperature:
Room temperature
STAT Availability:
24 hours daily
Specimen Retention:
4 hours
Test ID:
5181