What is the correct primary dose of TXA to administer?

The primary dose of tranexamic acid (TXA) for the treatment of severe trauma-related hemorrhage is generally established as 1 gram administered slowly through intravenous push (IVP) over a specific duration. The choice of administering 2 grams slowly over 1-2 minutes can be aligned with certain clinical protocols that allow for higher dosing in specific situations, typically beyond the standard recommendation.

Administering this dose slowly helps reduce the risk of potential adverse effects, such as hypotension, which can occur with rapid infusion. Additionally, a slower administration allows for better patient tolerance and the opportunity to monitor for any immediate reactions.

In trauma settings, the focus is on maximizing efficacy while ensuring safety, and a 2-gram dose is meant to boost the antifibrinolytic effect of TXA, thereby aiming to improve hemostatic outcomes during critical care situations. The establishment of such a regimen should be based on individual patient needs and clinical context rather than a one-size-fits-all approach.

Other choices either suggest faster administration or dosages that may not align with proper dosing practices for TXA, emphasizing the importance of adherence to established guidelines.