['hemorrhagic shock', 'trauma injury']
['tranexamic acid']

        Inclusion Criteria:

          -  Blunt or penetrating trauma with signs and symptoms of hemorrhagic shock

          -  Systolic blood pressure less than 90 mmHg at scene of injury, during air and/or ground
             medical transport, or on arrival to designated trauma centers

          -  Any sustained blunt or penetrating injury within 3 hours

          -  Patient who are considered to be at high risk for significant hemorrhage

               1. Estimated blood loss of 500 milliliters int he field accompanied with HR >120

               2. Bleeding not controlled by direct pressure or tourniquet

               3. Major amputation of any extremity above the wrists and above the ankles

        Exclusion Criteria:

          -  Any patient under 18 years of age

          -  Any patient with an active thromboembolic event (within the last 24 hours) i.e. active
             stroke, myocardial infarction, or pulmonary embolism

          -  Any patient with a hypersensitivity or anaphylactic reaction to TXA

          -  Any patient more than 3 hours post injury

          -  Traumatic arrest with > 5 minutes CPR without return of vital signs

          -  Penetrating cranial injury

          -  Traumatic brain injury with brain matter exposed

          -  Isolated drowning or hanging victims

          -  Documented cervical cord injury with motor deficit
      