Page 146 - Journal of Special Operations Medicine - Summer 2016

Question 1 Question 2

• For a trauma patient with ongoing life- • For a trauma patient with ongoing major
threatening extremity hemorrhage – what noncompressible blood loss – what is
is the best time to apply a tourniquet? the best time to reduce the bleeding?

• Within 1 hour? • Within 1 hour?
• Within 3 hours? • Within 3 hours?
• RIGHT NOW? • RIGHT NOW?

TXA Take-Homes Harvey – TXA
Annals Emerg Med 2014
• There is Level A evidence that TXA reduces mortality in
trauma patients.
• There is Level A evidence that TXA reduces blood loss in
elective surgery patients.
• There is Level A evidence that TXA does not increase the risk of
thromboembolic complications in elective surgery patients.
• (NOTED – that elective surgery is not trauma.)
• The best way to prevent death from hemorrhage is to
PREVENT blood loss.
• Likely more benefit if TXA is given as soon as possible after
injury
• 2016 - TXA added to USA Medical Equipment Set - COL Lance
Cordoni

ASDHA Letter on TXA What Can TCCC Offer to
9 October 2013 My Civilian EMS System?

• Tourniquets
• Hemostatic dressings
• Trauma airway approach
• TCCC Needle Decompression Plan
• Tranexamic Acid (TXA)
• Hypotensive resuscitation - with blood products where
• Response to CENTCOM Surgeon request possible
• TXA use no longer restricted to SOF and MTFs • Intraosseous vascular access
• Need to accumulate data; monitor outcomes • Triple-Option Analgesia

132 Journal of Special Operations Medicine Volume 16, Edition 2/Summer 2016