Under ALS standing orders, postpartum hemorrhagic shock is treated with tranexamic acid only under what condition?

• A. Base hospital order is required.
• B. Immediately upon childbirth regardless of orders.
• C. Only if patient is under 12.
• D. If there are signs of hemorrhagic shock meeting inclusion criteria.

Answer: (A)

The key idea here is that certain medications in ALS standing orders require physician authorization before they can be given. Tranexamic acid for postpartum hemorrhage is one of those drugs, so it can be used only when a base hospital order is in place. This ensures patient safety by allowing a clinician at the base to review the specific situation, check for contraindications (such as thromboembolism history, allergies, or kidney issues), and confirm timing within the recommended window. Without that base hospital order, the standing orders do not authorize TXA administration.

Other options don’t fit because they circumvent the required physician authorization, or they introduce irrelevant criteria (such as age) that aren’t the controlling factor in this protocol.