Summary of Changes
01 Sep 2023 update: DEVICE data regarding video laryngoscope.
June 2023 update
- Calcium administration changed to 1 gram calcium
- Tranexamic acid (TXA) 2gm bolus is now favored over the traditional 1gm prehospital bolus followed by 1gm infusion over 8 hours. The 2gm TXA bolus should be given as close to the time of injury as possible and not outside of the 3 hours window.
05 Apr 2021 updates
- Use Whole Blood (WB) if available. FDA-approved cold stored WB is preferred over fresh WB (non-FDA approved).
- Initiate infusion of 2gmTranexamic Acid (TXA) IV/IO ASAP or within 3 hours of injury
- Carefully follow calcium concentration during massive transfusion. Consider giving empiric calcium if hypotensive
- Stronger evidence exists for use of vasopressin in hemorrhagic shock. Consider vasopressin bolus of 2-4 units followed by a vasopressin infusion (0.04 U/min) in cases of refractory shock.