I recall during training last year that when administering txa via IV infusion that the saline used to mix the txa does not count towards the total amount of fluid therapy. My understanding of this reasoning is that the saline is the vehicle to getting the medication administered and not part of the fluid bolus. However, Many services are carrying mini bags of saline 100cc or less for this purpose. A smaller amount of saline is not a huge deal. However, our service only stocks 500cc bags. That seems like a large amount of fluid to just dismiss as drug administration. Would this practice of omitting the saline from the fluid therapy still apply under these circumstances or should we count the 500cc towards the fluid therapy? 

 Thank you for your excellent question. We have not been prescriptive in how to administer this medication. There are multiple options to consider including the intramuscular (IM) route in addition to IV which can be given by:  Slow push with 10mL syringe, buretrol, or any fluid diluent your service carries.  

After review of your question and careful consideration, SWORBHP Medical Council now recommends to count any diluent >100mL as part of the IV fluid administered. 

BLS,Trauma Patient,Traumatic Hemorrhage

Diluent, IM, IV, Medication administration, Medication Route, Tranexamic Acid, TXA

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