Il laboratorio di coagulazione nelle situazioni di emergenza

A definition of the role of the Coagulation laboratory in emergency clinical settings is far from being clear, based on the current organization of Italian laboratories. This is due in part to economic reasons, but mostly to a cultural problem. What is defined by the term "coagulative emergency" is a rare occurrence, which can however be encountered anytime. Under these circumstances, the laboratory is asked for a prompt and exhaustive diagnosis supportive of a rational therapeutic intervention. Herewith, examples are reported of a series of "coagulative emergencies" where the Coagulation laboratory can only provide a partial - if any - answer to the requests of the clinical counterpart. In the setting of critical care, the use of point-of-care devices is being increasingly adopted, and there are reports showing that in heart surgery departments computerized thromboelastography may result in a significant sparing of economic resources. Time has come for reconsidering the role of the coagulation "specialist" within the modern clinical laboratory.