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Major limb haemorrhage and TXA — DipIMC MCQ

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HardPre-Hospital Trauma ManagementMajor limb haemorrhage and TXADipIMC

A patient has suspected active internal bleeding after a machinery injury 45 minutes ago. Haemorrhage control and blood-product resuscitation are underway. Which antifibrinolytic treatment is indicated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Give IV tranexamic acid as soon as possible

The best answer is “Give IV tranexamic acid as soon as possible”. NICE recommends IV tranexamic acid as soon as possible in major trauma with active or suspected active bleeding. It should not be given more than three hours after injury unless hyperfibrinolysis is demonstrated. The early treatment runs alongside haemorrhage control and resuscitation; imaging or laboratory confirmation should not delay it when the clinical indication is already established.

Reference: NICE NG39, Major trauma: https://www.nice.org.uk/guidance/ng39/chapter/recommendations