Intramuscular Tranexamic Acid Administration on the Battlefield

Area of Science:

• Trauma Resuscitation
• Emergency Medicine
• Pharmacology

Background:

• Tranexamic acid (TXA) is a standard antifibrinolytic agent used to manage hemorrhage.
• Current administration routes include intravenous (IV) and intraosseous (IO) access.
• Exsanguination remains a leading cause of preventable death in trauma patients.

Observation:

• A patient with multiple high-powered rifle gunshot wounds received intramuscular (IM) TXA due to lack of IV/IO access in a battlefield environment.
• This administration route is not well-documented as a primary intervention in medical literature.
• The patient experienced a positive clinical outcome despite significant trauma and logistical challenges.

Findings:

• This case report details the successful use of IM TXA in a critical care scenario.
• The positive outcome suggests potential efficacy of the IM route for TXA administration.
• The use of IM TXA may have mitigated the severity of hemorrhage and coagulopathy.

Implications:

• Intramuscular TXA administration warrants further investigation as a viable alternative route.
• This route could be particularly advantageous in austere or resource-limited environments where IV/IO access is difficult.
• Wider acceptance of IM TXA could expedite treatment, improving hemorrhage control and patient outcomes.