Tranexamic Acid (TXA) is an anti-fibrinolytic medication used in trauma resuscitation, and is a foundational element of Damage Control Resuscitation (DCR).
TXA should be administered to all bleeding trauma patients, and those at risk of significant bleeding. If you transfuse, or consider transfusing, give TXA.
Give TXA ASAP, but do not administer if greater than 3 hours since injury.
TXA Dosing: 1 gram over 10 minutes, followed by a 1 gram drip over the next 8 hours.
Consider TXA in isolated TBI patients without significant extracranial hemorrhage.
The CRASH-2 Trial, the MATTERs Study, and the CRASH-3 Trial are the landmark studies defining TXA use in trauma.