Page 391 - ATP-P 11th Ed

c. Tranexamic Acid (TXA)
i. If a MWD is anticipated to need significant blood transfusion (for example:
presents with hemorrhagic shock, one or more major amputations, penetrating
torso or abdominal trauma, or evidence of severe bleeding):
ii. Administer 10mg/kg of tranexamic acid as a slow IV push or in 100mL Normal
Saline or Lactated Ringer’s as soon as possible but NOT later than 3 hours after
injury. When given, TXA should be administered over 10 minutes by IV/IO
infusion.
iii. Begin a second infusion of 10mg/kg of TXA as a continuous infusion over 8
hours after initial fluid resuscitation has been completed.
d. Fluid resuscitation
i. Assess for hemorrhagic shock (pale mucus membranes, inappropriate menta-
tion in the absence of head trauma, weak or absent femoral pulse).
ii. The resuscitation fluids of choice for MWDs in hemorrhagic shock, listed from
most to least preferred, are: canine chilled or fresh whole blood; canine plasma
and RBCs in a 1:1 ratio; canine plasma or RBCs alone; crystalloid (Lactated
Ringer’s, Normosol R or Plasma-Lyte A) Hextend/Hespan.
NOTE: Hypothermia prevention measures [number 7] should be initiated while
fluid resuscitation is being accomplished.
iii. If not in shock:
(a) No IV fluids are immediately necessary.
(b) Fluids by mouth are permissible if the MWD is conscious and can swallow.
iv. If in shock and canine blood products are available:
(a) Resuscitate with canine whole blood [initial dose is one 500mL unit as a SECTION 4
bolus or titrated depending on situation], or, if not available
(b) Canine plasma and canine RBCs in a 1:1 ratio [initial dose is one 250mL
unit of plasma plus one 250mL unit of pRBC bolused or titrated depending
on situation], or, if not available
(c) Reconstituted dried canine plasma, canine liquid plasma or thawed canine
fresh frozen plasma [initial dose is one 250mL unit of any of the above
mentioned plasma products bolused or titrated depending on situation]
alone or canine pRBCs alone [initial dose is one 250mL unit of pRBC bo-
lused or titrated depending on situation]
NOTE: DO NOT administer human blood products to a canine. Human blood
products have a high probability of causing a hemolytic reaction when trans-
fused into a canine.
(d) Reassess the MWD after each unit. Continue resuscitation until a palpable
femoral pulse, improved mental status or systolic BP of 80-90 is present.
v. If in shock and blood products are not available due to tactical or logistical
constraints:

ATP-P Handbook 11th Edition 381