TXA

[systemet]

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There's a great discussion of these issues here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336134/

(free .pdf / full text).

 

[DWR]

We just started to field it last week. For those that do carry it.. What are the indications? I ask this just because protocols are obviously different everywhere.

 

[cprted]

Mechanism of injury suggestive of major trauma and suspicion of ongoing occult bleeding or injuries identified during primary survey
AND
HR >110 or Systolic BP <90mmHg

Contraindicated if greater than 3 hours since injury occurred.

One of my concerns is that previously, we could pretty well tell people that there's never any reason to waste time on scene with an uncontrolled bleeder, and if they're delaying transport to fiddle with things like IVs then they're generally wrong to do that. Now if we say they should give TXA, well... now they have a reason to stay and play.

I dunno. Unintended consequences.

For my agency at least, not delaying transport has been hugely emphasized to our crews. Our guidelines state clearly that TXA is to be administered on route to hospital (except in circumstances like a prolonged extrication or something like that).

 

[DesertMedic66]