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Tranexamic Acid Use in Pediatric Hemorrhagic Shock From Farm-Related Trauma: A Case Report
Andrew D Cathers1, Jake Forsythe2, Nathan Sippel3
1UW Med Flight, Madison, WI; Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI.
Insights
Tranexamic acid, alongside tourniquets and blood products, effectively managed pediatric hemorrhagic shock from extremity trauma. Prompt prehospital interventions stabilized the child, ensuring a good recovery.
Area of Science:
- Emergency Medicine
- Pediatric Trauma Care
- Hemorrhagic Shock Management
Background:
- Hemorrhagic shock in children presents a critical challenge requiring rapid and multi-faceted interventions.
- Best practices include immediate bleeding control and aggressive fluid resuscitation with blood products.
Observation:
- A 20-month-old male sustained a severe right upper extremity injury from an agricultural accident, leading to significant hemorrhage and shock.
- Prehospital care involved tourniquet application, blood product administration, and tranexamic acid.
Findings:
- The combination of advanced prehospital interventions, including tranexamic acid, successfully stabilized the pediatric patient's hemodynamics.
- The child arrived at a pediatric trauma center hemodynamically stable and was discharged neurologically intact.
Implications:
- This case underscores the efficacy of tranexamic acid as an adjunctive therapy in pediatric hemorrhagic shock.
- Early and coordinated prehospital management is crucial for improving outcomes in pediatric trauma patients with severe hemorrhage.
Abstract:
This case describes the use of tranexamic acid as an adjunctive treatment in the management of a pediatric patient in hemorrhagic shock. The case also highlights other components of current best practices for hemorrhagic shock in children, including bleeding source control and prompt resuscitation with blood products. A 20-month old male suffered an agricultural accident with significant injury to the right upper extremity. This led to subsequent extremity hemorrhage and clinical evidence of hemorrhagic shock. As a result of interventions performed by emergency medical services as well as the helicopter emergency medical services team, including the application of a tourniquet, prehospital blood product administration, and tranexamic acid administration, the patient had hemodynamically stabilized by arrival at the level 1 pediatric trauma center and was neurologically intact when discharged from the hospital.
