TXA is an important therapy that will help increase patient’s survivability in an out of hospital hemorrhagic injury. ALS providers play a key role in knowing when to use TXA and how to properly administer the medication.
A few of you have noticed the discrepancy in TXA administration in the protocol versus what we have chosen to use jurisdictionally. We are choosing to utilize a 50 ml bag of Normal Saline with a 10 gtt set for ease of administration via drip over 10 minutes. Since the TXA concentration is 1 gram in 10 ml, when added to a 50 ml bag of normal saline – that equals a total amount of 60 ml to be administered. When the administration duration is 10 minutes or greater, one drop per second is the exact rate for a 10 gtt set. Please make sure you are giving TXA NO FASTER than this rate, as hypotension may worsen and seizures may occur.
Attached is a letter from JMD Dr. Martin with the jurisdictional option outlined.
Our 10 gtt sets have arrived and have gone out to some stations already. Corporation management and DES Captains, please reach out to me to arrange for pickup at Elliott or for me to bring to the stations.
Brandon Neuenschwander is working on a drip calculation chart for all of our drips as a quick reference; since there have been so many recent changes with availability of diluents and their amounts. If you have any questions or concerns, please do not hesitate to contact me.
We will be completing 100% Quality Assurance on all calls utilizing TXA – feel free to give me a heads up if you would like a case reviewed.
A few of you have noticed the discrepancy in TXA administration in the protocol versus what we have chosen to use jurisdictionally. We are choosing to utilize a 50 ml bag of Normal Saline with a 10 gtt set for ease of administration via drip over 10 minutes. Since the TXA concentration is 1 gram in 10 ml, when added to a 50 ml bag of normal saline – that equals a total amount of 60 ml to be administered. When the administration duration is 10 minutes or greater, one drop per second is the exact rate for a 10 gtt set. Please make sure you are giving TXA NO FASTER than this rate, as hypotension may worsen and seizures may occur.
Attached is a letter from JMD Dr. Martin with the jurisdictional option outlined.
Our 10 gtt sets have arrived and have gone out to some stations already. Corporation management and DES Captains, please reach out to me to arrange for pickup at Elliott or for me to bring to the stations.
Brandon Neuenschwander is working on a drip calculation chart for all of our drips as a quick reference; since there have been so many recent changes with availability of diluents and their amounts. If you have any questions or concerns, please do not hesitate to contact me.
We will be completing 100% Quality Assurance on all calls utilizing TXA – feel free to give me a heads up if you would like a case reviewed.
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 301-491-2454 (office) 240-313-4376 (fax) 240-313-4375
TXA-Administration.pdf