#127 – The use of TEG 6s in Trauma Resuscitation – Nathan Bowser

My guest today is Nathan Bowser, a 3rd Doctor of Nursing Practice resident in the University of Arizona‘s nurse anesthesia program. Nathan is the lead author on a paper published in the August 2026 edition of the AANA Journal titled “Use of Thromboelastography 6s in Trauma: An Integrative Review for Anesthesia Providers.” In this article Nathan and his co-authors outline the literature pertinent to Haemonetic’s new TEG 6s device, which presents substantial advances over their older TEG 5000 device. This new device is one of several in the market that bring thromboelastography to the point of care, which has significant implications for improving targeted transfusion during trauma resuscitation. Nathan and I walk through the clinical context of trauma resuscitation, in which up to 30% of severely injured patients arrive to the hospital in a trauma-induced coagulopathy (TIC). He then walks us through how having a cartridge-based point of care TEG device can speed time to transfusing the products your patient actually needs. The device is also useful for reducing the total number of blood products delivered and helping clinicians know when to slow down or even stop transfusion. At the end of the show, we talk a bit about Nathan’s process and motivation as a DNP resident to push his doctoral project through to submitting for publication and then producing this podcast. If you’re in to trauma resuscitation, blood product management or curious about how to find topics for and structure your DNP or residency project, this is a great show for you. Huge shout out to Nathan Bowser for putting the work in and to Dr Kristie Hoch, the program director at the University of Arizona’s nurse anesthesiology program for connecting Nathan and me. If you’re a critical care RN considering anesthesia training, definitely take a look at the University of Arizona’s program – Dr Hoch has been at the helm for years and has been working hard to develop the program and support her doctoral students. In other news, our CRNA team at MaineHealth just got back from the AANA Annual Congress in Boston a few weeks ago. We were thrilled to see a bunch of old friends and to meet the future of our profession in all of the nurse anesthesiology trainees and critical care nurses at the conference. I’m also looking forward to a seeing some of you at Encore Symposium’s fall conference in Bar Harbor, Maine in October and then in O’ahu, Hawaii in November. I’ve committed to join Encore again next October back at the Cliff House so if you’re looking for a 2027 conference to attend, scope out the scene with Encore Symposium’s conference at the Cliff House in Maine next October. And with that, let’s get to the show! Resources from Nathan: General review of Viscoelastic devices- https://pmc.ncbi.nlm.nih.gov/articles/PMC9903681 Thromboelastography on fixed wing- https://pmc.ncbi.nlm.nih.gov/articles/PMC11272443 Fibrinolytic shutdown- https://journals.lww.com/journalacs/abstract/2024/07000/differentiating\pathologic\from\_physiologic.5.aspx https://journals.lww.com/journalacs/abstract/2017/04000/persistent\fibrinolysis\shutdown\is\associated.34.aspx https://pmc.ncbi.nlm.nih.gov/articles/PMC4443855 https://journals.lww.com/journalacs/abstract/2016/04000/acute\fibrinolysis\shutdown\after\injury\_occurs.2.aspx Cell-based Model for Hemostasis > The Cell-Based Model of Coagulation