ABSTRACT
The severely injured patient, with multiple injuries to different body systems, poses unique diagnostic and treatment challenges. The early assessment and management of severe trauma begins in the prehospital environment. The role of the trauma team is to apply the principles of Advanced Trauma Life Support to rapidly identify and treat life-threatening injuries during the primary survey. Tranexamic acid is an antifibrinolytic drug that reduces the risk of mortality from bleeding in both blunt and penetrating trauma. One gram is given intravenously over 10 minutes, followed by a further 1-g dose over 8 hours. The sites of major haemorrhage in trauma patients are the chest, abdomen, pelvis and long bones, and external haemorrhage. Blunt trauma patients frequently have multiple sources of haemorrhage. All severely injured patients require a detailed top-to-toe examination after life-threatening injuries have been identified and managed during the primary survey.
