This case describes the use of tranexamic acid as an adjunctive treatment in the management of a pediatric patient in hemorrhagic shock. The case also highlights other components of current best practices for hemorrhagic shock in children, including bleeding source control and prompt resuscitation with blood products. A 20-month old male suffered an agricultural accident with significant injury to the right upper extremity. This led to subsequent extremity hemorrhage and clinical evidence of hemorrhagic shock. As a result of interventions performed by emergency medical services as well as the helicopter emergency medical services team, including the application of a tourniquet, prehospital blood product administration, and tranexamic acid administration, the patient had hemodynamically stabilized by arrival at the level 1 pediatric trauma center and was neurologically intact when discharged from the hospital.
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