Pre Hospital Care For Trauma Patients With Massive Hemorrhage Essay

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Massive hemorrhage is a leading cause of preventable death amongst both civilian and military populations (Abramovich et al., 2013). Pre-hospital care for trauma patients with massive hemorrhage mainly focuses on bleeding control and rapid transport (Hafen, Karren, & Mistovich 2013), but recent studies on the use of tranexamic acid (TXA) as an “anti-clot buster” have sparked interest in development of protocols allowing pre-hospital administration of the drug by EMS agencies in treatment for traumatic hemorrhage (Fox 2016). As an antifibrinolytic drug, TXA works to inhibit the breakdown of clots and reduce blood loss in trauma patients to fight the onset of hemorrhagic shock (Dubose et al., 2012). Following massive trauma, the body’s coagulative response works to promote normal clotting but this process is highly influenced by fibrin breakdown, which works to break down the clots formed as products of coagulation. In patients with hyperfibrinolysis, increased clot breakdown can lead to fatal bleeding and organ failure (Fox 2016). Use of TXA in such patients can potentially work to enhance clot formation and reverse this enhanced fibrinolytic process but studies are being done to prove its benefits in trauma patients with normal fibrinolytic responses as well. Although it was first approved by the FDA in 1986 for treating hemophiliac patients during oral surgery and has been used for decades in cardiovascular surgery to reduce blood loss (Fox 2016), the use of TXA in

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