TXA timing late trauma — DipIMC MCQ

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HardPharmacologyTXA timing late traumaDipIMC

A cyclist with suspected internal bleeding crashed four and a half hours ago in a remote area. He is hypotensive and now reaches the rescue team. What is the most appropriate drug/dose?

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Correct answer: B — Do not give TXA solely for trauma haemorrhage beyond the recommended time window

Do not give TXA solely for trauma haemorrhage beyond the recommended time window is the best answer because TXA benefit in traumatic bleeding is time-dependent and is not recommended when presentation is beyond the accepted window. Give aspirin 300 mg for traumatic pain is less appropriate because antiplatelet therapy does not treat traumatic haemorrhage or pain; Give oral medication and reassess at hospital is less appropriate because oral treatment is slow and unreliable in major trauma. Give intramuscular morphine 20 mg as a fixed dose and Withhold the drug until laboratory confirmation is available are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: NICE Major Trauma NG39; JRCALC Guidelines