Tranexamic acid dosing for eligible patients is:

• A. 0.5 g IV push
• B. 1 g in 50-100 mL NS IV/IO over 10 minutes
• C. 1 g IM
• D. 2 g IV/IO over 10 minutes

Answer: (B)

The important idea here is administering tranexamic acid in a way that provides rapid, controlled exposure to help reduce bleeding. For eligible patients, the standard approach is to give 1 gram IV or IO infused over about 10 minutes, typically reconstituted in 50–100 mL of normal saline. This infusion method delivers the dose evenly and minimizes risks that can come with a rapid push or alternate routes. The other options don’t match the common protocol: a smaller IV push dose doesn’t achieve the same bloodstream levels quickly enough; IM administration is not the recommended route for this drug in most standing orders; and giving 2 grams IV/IO over 10 minutes goes beyond the usual initial EMS dose unless a protocol explicitly allows it. The key is timely, controlled infusion of 1 gram to help blunt fibrinolysis during significant bleeding.