TRANEXAMIC ACID IN TRAUMA AND TRAUMATIC BRAIN INJURY
TRANEXAMIC ACID IN TRAUMA AND TRAUMATIC BRAIN INJURY PATIENTS INDICATIONS FOR USE IN TRAUMA 1. 2. 3. 4. Either SBP <90 mm. Hg (for patients > 12 years) Or HR >110 (for patients > 12 years) Neither of the above but still considered to be at risk of significant internal or external haemorrhage (all ages) And within 8 hours of injury INDICATIONS FOR USE IN TRAUMATIC BRAIN INJURY 1. 2. 3. Has the patient had a head injury? Has the injury occurred within the last 3 hours? Is the GCS 12 or less? If the answer to all three questions is yes, administer 1 g Tranexamic Acid IV ASAP IF PATIENT IS FOUND TO HAVE A GCS 13 -15 THEN CONSIDER • • Does the CT scan show a traumatic brain injury? Is it less than 3 hours since injury? If the answer to both questions is yes, administer 1 g tranexamic acid IV ASAP ADULTS CHILDREN Loading dose 1 g tranexamic acid in 100 ml 0. 9% sodium chloride given over 10 minutes immediately followed by Infusion of 1 g tranexamic acid in 500 ml 0. 9% sodium chloride given over 8 hours Loading dose 15 mg/kg (maximum 1 g) tranexamic acid in 20 ml 0. 9% sodium chloride given over 10 minutes, immediately followed by Infusion - see SORT Children’s Major trauma guidelines for dosing schedule of infusion CONTRA–INDICATIONS. The only absolute contra–indication is thromboembolic disease – more specifically - clinical evidence of a thrombotic disseminated intravascular coagulation. Please see micro-guide for more information. ~ Updated by Dr Sarah Assheton ED Consultant & Dr Claire Whaley (May 2020)
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