Hemorrhage

General Trauma or Medical COG needs to be starting point - then:

• Inclusion criteria

a. Adult (18 y/o or older) trauma patient with known or suspected hemorrhage

i. Intra-thoracic, intra-abdominal, pelvic or long bone fractures

b. Systolic blood pressure < 90 mmHg OR heart rate > 100 OR both

c. Time of injury < 3 hours

• Contraindications

a. Pediatric patients (< 18 y/o)

b. Isolated head trauma

c. Known thromboembolic disease (PE, DVT, MI)

d. Known hypersensitivity to tranexamic acid

• Dosage

Major trauma or potential internal bleeding 

 Infuse TRANEXAMIC ACID (TXA) 1,000 mg (1 gram) slow IV push over 1 minutes IV/IO

Nosebleed

Soak a piece of gauze with TXA 500 mg and insert into bleeding nostril with pressure applied to the nose

Persistent bleeding despite use of tourniquet

Soak gauze dressing with TXA 500 mg and insert into wound with pressure dressing

Post-operative tonsillectomy hemorrhage

TXA 500 mg via nebulized solution 

• Documentation

a. Documentation should include rational for administration including vital signs prior to and after administration