Postoperative Tonsillectomy and Adenoidectomy (T&A) Bleed Clinical Pathway – Emergency Department, Inpatient and PICU – Tranexamic Acid and Racemic Epinephrine

Postoperative Tonsillectomy and Adenoidectomy (T&A) Bleed Clinical Pathway – Emergency Department, Inpatient and PICU

Tranexamic Acid and Racemic Epinephrine

Agent Dose/Administration Comments
Tranexamic Acid
  • Nebulized
    • < 25 kg
      • 250 mg diluted 1 mL of NS 0.9%
    • ≥ 25 kg
      • 500 mg diluted 1 mL of NS 0.9%
  • Intravenous
    • 10 mg/kg/dose IV once
      Max 1000 mg
  • Contraindicated if history of thromboembolic events
  • Caution if risk for seizures
  • Deep vein thrombosis, pulmonary embolism, retinal vein occlusion and retinal artery occlusion have been reported
Racemic Epinephrine 0.25–0.5 mL diluted in 3 mL NS 0.9%
  • Use with caution if cardiac disease
  • Consider if TXA not available