Mosa Safi/LinkedIn
May 21, 2026, 13:08
Mosa Safi: Updated TXA Recommendations in Tactical Combat Casualty Care
Mosa Safi, Senior Medical Instructor at Prometheus Medical International, shared a post on LinkedIn:
“Tranexamic Acid (TXA) is now given as a single 2 g slow IV/IO push, replacing the older protocol of 1 g over 10 min and 1 g infusion over 8 hrs.
Current TCCC indications
Give TXA ASAP (within 3 hours of injury) if casualty has:
- Hemorrhagic shock / expected major transfusion
- Major amputation
- Penetrating torso trauma
- Severe bleeding
- Significant TBI or altered mental status after blunt/blast trauma.
Current TCCC Dose
TXA 2 g IV/IO slow push (single dose)
Why the change?
- Simplifies care in austere/combat settings
- Reduces missed second doses
- Emerging evidence suggests potential benefit in severe TBI
- Less cognitive load during prolonged evacuation
Important
Benefit decreases with delayed administration.
After more than 3 hours, TXA may lose benefit and potentially increase harm in bleeding trauma.
Teaching pearl
‘Early TXA matters more than perfect TXA dosing.’
Bottom line
- TCCC moved from 1 g and 1 g infusion – single 2 g TXA dose
- Include severe TBI among TXA indications
- Administer as early as possible and within 3 hours of injury.”

Stay updated with Hemostasis Today.
-
Oct 8, 2026, 11:06Houman Khosravani: Stroke and Thrombosis – Bridging Neurology and Hemostasis
-
Oct 8, 2026, 04:28Jeff Molter: Electrophysiological PIEZO1 Analysis Advances Diagnosis in Hereditary Xerocytosis
-
Oct 8, 2026, 04:23Barbara Adams Krolak: Women and Blood Clots Are We Missing the Warning Signs
-
Oct 8, 2026, 04:10Rutendo Muzambi: Hospital Admission Patterns and Care Disparities in Sickle Cell Disease
-
Oct 8, 2026, 03:50Olfat Berro: Redefining the Future of Haemophilia A
-
Oct 8, 2026, 03:35Tasnia Tarana: Heavy Menstrual Bleeding When the Cause Is Not in the Uterus
-
Oct 8, 2026, 03:28Kian Haseli: Electrophysiological PIEZO1 Analysis Advances Diagnosis in Hereditary Xerocytosis
-
Oct 8, 2026, 03:20Sthanu Subramanian: Leukopenia in Sepsis A Marker of Severe Disease
-
Oct 7, 2026, 16:44Amor Salah: 2026 NCS/SCCM Guidelines for Managing Antithrombotic-Associated ICH