TXA in Trauma

Colleagues,

you have a trauma patient:
middle age male, intoxicated, MVC 40 mph, hits tree with major intrusion to drivers side, seat belted, 30 min extrication time, arrival 1.5 hrs post accident. patient c/o pain left chest and pelvis/lower back pain, mild tachycardia in field improves with 100 mcg fentanyl, arrives with normal vitals, primary survey normal except left chest wall tender, tender left abdomen, pelvis stable, gcs 15, FAST normal.

Give Tranexamic acid?

pan scan reveals a few left rib fxs without pneumo/hemo, no intrabdominal injuries, small blush in retroperitoneum and small hematoma. hgb 15.9, other labs normal except lactate 2.9

Give TXA now? approximately 2 hrs from injury

patient has episode of sbp mid 80’s s, Give TXA?

I know we did a jc on this a couple years ago, but this is a great  review article and emcrit post below.
check out page 1582 for article summary.
http://emcrit.org/wp-content/uploads/2012/02/TXA-in-trauma-How-should-we-use-it.pdf

Podcast 67 – Tranexamic Acid (TXA), Crash 2, & Pragmatism with Tim Coats

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