The use of TXA – both bolus and follow-up infusion – is important in the resuscitation of all trauma patients with the potential for major blood loss. It’s also appropriate to consider in the setting of suspected intracranial injury – even before imaging.

Equally important is knowing where to find the equipment to control major bleeding! Taking the time to review locations of TXA, tourniquets, pelvic binders and radio-opaque (x-ray detectable) gauze in your local ED can absolutely help you save a life.

All Trauma Centres in NB should have a process to activate Massive Transfusion for the patient experiencing major blood loss, including easy access to blood products in your facility. Because frequency is low, making sure you are familiar with how this works is important – consult with Trauma NB if you are unsure of local policies or processes.

Portable chest and pelvis X-rays are appropriate early imaging modalities for most trauma patients. We also continue to recommend consultation with the Trauma Control Physician (TCP) for guidance around pan-scanning vs. selective CT, as well as advanced imaging in pediatric patients.

TCP consultation also is strongly recommended for patients with significant mechanisms of injury resulting in blunt trauma to the head, neck or upper chest/back. CT Angiography, either at the sending site or upon arrival in transfer to a larger centre, is an important consideration to rule out dissection of major blood vessels in the neck.

Although bolus doses of both analgesia and sedation are great starting points for patients after intubation, setting them up on infusions for both medications is recommended, particularly for those hitting the road on transfer. Check out our guidance on this and other injury topics at: consensus statements.

We’re working hard with the team at FirstLine (formerly Spectrum) on the Beta version of the Trauma NB App! Our final release will include EMS and hospital decision support for important clinical presentations, including burns, traumatic brain injuries, pelvic fractures and others. Stay tuned for more news on this topic!