We have a young (15) female patient in that has been diagnosed with Hereditary Angioedema. This Pt has had some severe episodes in the past and has required intubation and admittance into the ICU multiple times. I have completed interfacility transports with this patient from one hospital to another. Upon acquiring information from the sending Physician and his treatment in the ER was Epinephrine and Benadryl which he admitted does little to no help for the condition. He then told me that he was also treating with TXA because it inhibits bradykinin formation. My question is since we carry TXA and this is a known condition (HAE) for this Patient could the crew patch and ask for an order for TXA in the pre-hospital environment since the Patient does not fit into our moderate or severe allergic reaction protocol ? Since this is not an allergen based reaction and yet is still a life threatening.

Would a traumatic VSA patient meet the indications for TXA (hypotension)? I appreciate that it would not be a priority but rather if you had the extra time and resources after any other interventions and after transport.

In the fireside chat part two for the ALS PCS 5.4 (at the 1hr 31min mark), Dwayne Cottel mentions an isolated head injury is just the head, nothing else. I’m understanding that to mean that if I have a multi-system trauma, I’m suspecting bleeding elsewhere in the body, I can give TXA regardless if I believe the head is also affected? So in other words, having a head injury doesn’t make TXA an absolute no UNLESS I’m thinking the head injury is the only injury or the only source of bleeding?