2026 Southeastern Residency Conference

Evaluation of Alternative Dosing of Tranexamic Acid in Adults with Traumatic Injuries 
Terence Natt, Madison Schwartz, Kevin Lynch, Dana Thorvilson 

CaroMont Regional Medical Center - Gastonia, NC 

Background/Purpose: Timely and proper dosing of tranexamic acid (TXA) in traumatic bleeding is imperative to reduce patient mortality. There is limited literature evaluating alternative dosing strategies to ensure TXA is consistently administered to patients that meet criteria. The purpose of this study is to determine if alternative dosing of TXA 2-grams administered intravenously over 10 minutes improves survival outcomes compared to standard dosing of a 1-gram intravenous (IV) bolus over 10 minutes followed by a 1-gram infusion over 8 hours.   

Methodology: Eligible patients were those >18 years old who met traumatic hemorrhage protocol criteria and were provided TXA by Gastonia Emergency Medical Services (GEMS) or in CaroMont Regional Medical Center’s emergency department (ED). The retrospective phase included patients who received standard dosing of TXA. Following protocol changes enacted in January 2026, the prospective phase included patients who received a 1-gram IV bolus of TXA in the ED following a 1-gram TXA administration by GEMS or received 2- grams of TXA as an IV bolus administered over 10 minutes in the ED. A chart review was completed to determine the primary endpoint of patient survival at 28 days, and secondary endpoints including change in heart rate and systolic blood pressure from initial presentation to 1 hour after TXA administration, blood product administration, ICU and hospital length of stay, and adverse drug events related to TXA administration). 

Results: In progress 

Conclusion: In progress