Page 44 - JSOM Fall 2020

– Administer 2g of tranexamic acid via slow IV or IO Acknowledgments
push as soon as possible but NOT later than 3 hours The authors gratefully acknowledge the research assistance
after injury (if not previously administered). provided by Mrs. Danielle Davis of the Joint Trauma System.
The authors also thank the Department of Defense Trauma
Level of evidence: Registry for providing much of the casualty data discussed in
The levels of evidence used by the American College of Car- this paper.
diology and the American Heart Association were outlined by
Tricoci P, et al. : Disclaimers
165
The opinions or assertions contained herein are the private
Level A: Evidence from multiple randomized trials or views of the authors and are not to be construed as official or
meta-analyses. as reflecting the views of the Defense Health Agency or the De-
Level B: Evidence from a single randomized trial or non-ran- partment of Defense. This recommendation is intended to be
domized studies. a guideline only and is not a substitute for clinical judgment.
Level C: Expert opinion, case studies, or standards of care.
Disclosures
2g dose of TXA in TBI = B The authors have nothing to disclose.
2g dose of TXA in hemorrhagic shock = C
Single dose of TXA in TBI = B Release
Single dose of TXA in hemorrhagic shock = C This document was reviewed by the Chief of the Joint Trauma
Administration of TXA through IO access = C System and by the Public Affairs Office and the Operational
Administration of TXA through slow IV push = C Security Office at the DoD’s Defense Heath Agency. It is ap-
Redose of TXA = C proved for unlimited public release.
Administration of TXA with blood/blood products = C

References can be found online at
https://jsom.us/2Z2io0G

*Corresondence to brendon.g.drew.mil@mail.mil
6
1 CAPT Drew, DO, USN, is the chair of the Joint Trauma System Com- surgical teams in support of overseas contingency operations. Col
mittee on Tactical Combat Casualty Care. He currently serves as the (Ret) Dorlac, USAF, is a trauma and critical care surgeon and medical
1st Marine Expeditionary Force Surgeon and the Navy Emergency director with the University of Colorado Health system. In his 26
Medicine Specialty Leader. He has eight deployments across Asia, Af- years of service with the Air Force, he served in numerous positions to
ghanistan, Iraq, and Africa and 11 ships in support of both USMC and include the trauma consultant to the USAF surgeon general, director
2
SOCOM units. CDR Auten, DO, USN, is the program director of the of the CSTARS military-civilian program at the University of Cincin-
Emergency Medicine Residency at Naval Medical Center San Diego nati, trauma medical director at Landstuhl, Germany, from 2004 to
and director, Combat Trauma Research Group West. He has served as 2007, and as the Joint Theater Trauma System deployed director for
a Carrier Airwing Flight Surgeon, US Marine Corps Shock Trauma CENTCOM in 2009. He is currently a subject matter expert for the
7
Platoon leader, and Detachment OIC for SOUTHCOM humanitarian Department of Defense’s Committee on TCCC. Colonel DuBose,
efforts. He has a wide area of research involvement in prehospital and USAF, serves as director, Center for the Sustainment of Trauma and
austere medicine with specific interests in pediatric trauma, hemostatic Readiness Skills (CSTARS) at R Adams Cowley Shock Trauma Center/
resuscitation, and intraosseous blood transfusion. COL Cap, MC, University of Maryland in Baltimore, MD. He is a professor of surgery
3
USA, is division chief, Acute Combat Casualty Care Research, US at USUHS and the University of Maryland and is board certified in
Army Institute of Surgical Research. He first trained and worked as an general surgery, vascular surgery and surgical critical care. He has over
EMT, and then as an internist, hematologist, oncologist, and specialist 230 published peer-reviewed publications as an active duty military
in stem cell transplantation, coagulation disorders, and transfusion surgeon with the US Air Force and has deployed seven times as a
medicine. He is the hematology and oncology consultant to the Army trauma surgeon to combat theaters in both conventional and JSOC
Surgeon General and has consulted extensively for the Joint Trauma roles. MAJ Fisher, PA-C, ARNG, is a physician assistant in the Texas
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System and Special Operations Command. He serves as co-chair of the Army National Guard, a recent graduate from the Texas A&M Uni-
NATO Blood Panel. CDR Deaton, MD, USN, is the 1st Marine Divi- versity College of Medicine, and a general surgery resident at the Uni-
4
sion surgeon and most recent chair of Emergency Medicine at Naval versity of New Mexico School of Medicine. He previously served on
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Medical Center San Diego. As a prior flight surgeon and dive medical active duty as a physician assistant within USASOC. SSG Ginn, USA,
officer, he has 13 deployments in support of USMC and SOCOM is a Special Operations combat medic and NREMT Paramedic. He has
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units. MAJ Donham, MD, USA, is the director of operational medi- extensive experience as a point of injury care provider over multiple
cine at the Carl R. Darnall Army Medical Center’s Emergency Medi- interagency and joint task force deployments. He is currently serving as
cine Residency Program and has multiple deployments with austere a company senior medic with the 1st Battalion, 75th Ranger Regiment.
42 | JSOM Volume 20, Edition 3 / Fall 2020