Practice Recommendations for the Use of Tranexamic Acid (TXA) in Paediatric Trauma

These clinical practice recommendations provide interim guidance on the use of tranexamic acid (TXA) as an adjunct in paediatric trauma within the Western Cape. Although TXA has established efficacy in adult trauma and surgical settings, the evidence for its use in children with major trauma remains limited. Given the high burden of trauma in South Africa, delays in definitive haemorrhage control, and the favourable safety profile of TXA, these recommendations aim to support pragmatic, context-specific decision-making for its cautious use. This guidance was developed through structured expert consensus and contextual appraisal of the available evidence and local practice patterns.