6.4 Tranexamic Acid

Eligible patients:

• Patients with blunt or penetrating trauma mechanisms suffered in the past 3 hours, 

• who appear age 5 or over and 

• show signs of significant hemorrhage (SBP < 90 mm Hg, HR > 110 BPM), or 

      if the EMT determines the patient to be at high risk for significant hemorrhage.

• Pregnant trauma patients and trauma patients on blood thinners are eligible. 

• Post-partum patient with bleeding complication

Dose: 

• TXA is given 15mg/kg to maximum dose of 1 gram IV over 10 minutes.

Timing:

• Treat early. 

Contraindications/Allergies:

• Greater than 3 hours since the event. 

• Known allergy to TXA.

Side effects: 

• Hypotension (if given too fast). 

• Seizures (if too much is given).

EMT STANDING ORDERS

1.0 Routine Patient Care

• Control/stop any identified life threatening hemorrhage (direct pressure, tourniquet, etc.), suspected pelvic fractures with commercial device (preferred) or bed sheet.

ADVANCED EMT STANDING ORDERS 

• Initiate 1-2 large bore IV(s) Normal Saline (KVO) while en route to the hospital.   

MEDICAL CONTROL MAY ORDER

• Additional fluid boluses. 

PARAMEDIC STANDING ORDERS

• For a patient over > 5 years of age, who has SBP< 90 or HR >110 BPM, or  if the provider determines the patient to be at high risk for significant hemorrhage:

       Tranexamic Acid (TXA) 15mg/kg to maximum dose of 1 gram IV over 10 minutes (mix 1 gram of TXA in 100ml of Normal Saline).

MEDICAL CONTROL MAY ORDER

•     For a patient under 5 years of age: Medical Control may order TXA as above.