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Major haemorrhage (tranexamic acid) — DIPIMC MCQ

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ModeratePre-Hospital TraumaMajor haemorrhage (tranexamic acid)DIPIMCDipIMC

A man has been stabbed in the thigh and is in haemorrhagic shock. The injury occurred 45 minutes ago and external bleeding has been controlled with a tourniquet.

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

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Correct answer: A — Intravenous tranexamic acid 1 g

Explanation lettering: E = shown as B · B = shown as C · C = shown as E

Tranexamic acid 1 g should be given to a bleeding trauma patient as early as possible and within three hours of injury, as the CRASH-2 evidence shows mortality benefit that is lost, and possibly reversed, beyond that window. Hydrocortisone (B) and vitamin K (E) have no role in acute traumatic haemorrhage. Give TXA early - timing is everything.

Reference: CRASH-2; JRCALC Clinical Guidelines; NICE NG39