The Use of Tranexamic Acid in Tactical Combat Casualty Care: TCCC Proposed Change 20-02

Brendon Drew, Jonathan D. Auten, Andrew P. Cap, Travis G. Deaton, Benjamin Donham, Warren C. Dorlac, Joseph J. DuBose, Andrew D. Fisher, Alan J. Ginn, James Hancock, John B. Holcomb, John Knight, Albert Ken Koerner, Lanny F. Littlejohn, Matthew J. Martin, John Kip Morey, Jonathan Morrison, Martin A. Schreiber, Philip C. Spinella, Benjamin WalrathFrank K. Butler

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


The literature continues to provide strong support for the early use of tranexamic acid (TXA) in severely injured trauma patients. Questions persist, however, regarding the optimal medical and tactical/logistical use, timing, and dose of this medication, both from the published TXA literature and from the TCCC user community. The use of TXA has been explored outside of trauma, new dosing strategies have been pursued, and expansion of retrospective use data has grown as well. These questions emphasize the need for a reexamination of TXA by the CoTCCC. The most significant updates to the TCCC Guidelines are (i) including significant traumatic brain injury (TBI) as an indication for TXA, (ii) changing the dosing protocol to a single 2g IV/IO administration, and (iii) recommending TXA administration via slow IV/IO push.

Original languageEnglish
Pages (from-to)36-43
Number of pages8
JournalJournal of special operations medicine : a peer reviewed journal for SOF medical professionals
Issue number3
StatePublished - 1 Sep 2020


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