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.
-
Jul 3, 2026, 09:33Abdul Mannan: Not All Type 1 VWD Starts in the VWF Gene
-
Jul 3, 2026, 09:18Aryabhatta Sadhu: Sickle Cell Crisis – When Diagnostics Should Change Therapy
-
Jul 3, 2026, 05:55New Evidence Supports Chromogenic Assays After Hemophilia A Gene Therapy – JTH
-
Jul 3, 2026, 05:50Jacopo Parizzi: Roche’s Non-Malignant Hematology Team Is Looking Ahead to 2027
-
Jul 3, 2026, 05:25Brian A Beh: A New Approach from The George Institute for Global Health Could Transform Stroke Care Before Hospital Arrival
-
Jul 3, 2026, 05:22Deirdre Finnigan: New Insights into Red Blood Cell Biomechanics in Cancer-Associated Anemia
-
Jul 3, 2026, 05:15Danielle Boyle: Collaboration Across Borders Is Helping Shape the Future of ITP Care
-
Jul 3, 2026, 05:05Claire McIvor: One Year at the Stroke Association and Grateful for a Workplace That Made It Possible
-
Jul 2, 2026, 23:11Michael Makris: Join The Cancer Associated Thrombosis Workshop at ISTH 2026