Tranexamic acid timing — DipIMC MCQ

Correct answer: A — Tranexamic acid 1 g IV now

Option A is correct because Early tranexamic acid is indicated in major trauma with active or suspected active bleeding, and benefit is time-critical. Waiting until hospital wastes the therapeutic window, while crystalloids are not a substitute for haemostatic treatment. The teaching point is to give TXA as soon as possible when traumatic haemorrhage is suspected and within the accepted time window. Option C is less appropriate because that dose is an ALS cardiac-arrest dose and is unsafe for this non-arrest indication; option B is less appropriate because aspirin is useful in ACS but inappropriate for this presentation. Option E is less appropriate because untitrated opioid dosing can cause avoidable hypotension or respiratory depression; option D is less appropriate because steroids have delayed onset and should not replace the immediate treatment. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: NICE Major Trauma NG39; JRCALC Guidelines