Table 2.

Recommendations for use of pharmacological adjuncts

		Administration/dose
Topical haemostatic agents
Indications	To arrest bleeding in areas where the anatomical access is difficult
Recommendations	Combat Gauze, Z-Medica, Wallingford, CT	Pack gauze into wound and apply manual pressure for 3 min
Systemic haemostatic agents
Indications	To arrest heavy bleeding that cannot be controlled with direct pressure or application of topical haemostatic agents
Recommendations	Tranexamic acid (TXA), Pfizer	Dose: 1 g infused over 10 min, repeated as indicated Use within 3 h from the traumatic event, but preferably within 1 h Pre-hospital use is advocated TXA should be included in every trauma resuscitation protocol