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TXA reduces bleeding by inhibiting the breakdown of fibrin blood clots (hyperfibrinolysis). It does this by binding to plasminogen stopping plasmin-mediated lysis. TXA concentrations need to be at least 5-10mg/L. However, the time above that threshold (area under the curve above the minimal effective concentration) is unclear, and probably needs to be prolonged. This is why it's always better to use TXA infusions (or bolus + infusion) rather than bolus alone. The bolus alone may not provide your patient sufficient anti-fibrinolysis time. journals.lww.com/bloodcoagul… #emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #meded #icu #criticalcare #trauma #military #navy #airforce #marines #blood #txa #science #data #research #medx #medtwitter

Can't intubate, can't ventilate - you've tried the bowling ball 🎳 technique, and an SGA won't seat (or their face is missing). You have to cric. Use the 4-step method the US military has perfected over the past 1.5 decades. 1. Knife 🔪 - 4+ cm incision of the neck (this is not the time to be dainty), 1cm incision of cric membrane 2. Finger - insert into new airway to hold position 3. Bougie - insert into trachea, will stop around 10cm 4. Tube - insert your tube over the bougie (Video from Rich Levitan -- FYI, I have no financial COIs other than DoD funding) youtu.be/xMFH8_nQZ50 #emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #tip #meded #trauma #icu #criticalcare #meded #airway #medic #combatmedic #military #navy #airforce #marines #prehospital #medx #medtwitter