Uncontrolled bleeding is a leading cause of death after traumatic injury. Evidence from large-scale randomized trials shows that urgent treatment with tranexamic acid (TXA) reduces bleeding deaths and all-cause mortality, without increasing the risk of thrombotic adverse events. TXA also reduces head injury deaths in patients with traumatic brain injury.
1. The casualty will likely need a blood transfusion (for example: presents with hemorrhagic shock, one or more major amputations, penetrating torso trauma, or evidence of severe bleeding).2. The casualty has signs or symptoms of significant TBI or has altered mental status associated with blast injury or blunt trauma.
2 g of TXA slow IV or IM push within 3 hours from trauma!
In one 10 ml syringe is 1 gram of TXA. Idealy apply 2 grams (both syringes) slow IV push (if you are able establish IV access) or IM via lower extremity (musculus vastus lateralis, musculus gluteus medius). Pierce the skin in 90 degree angle and continue until you reach the muscle – aspirate – if there are no blood – push TXA into the muscle.