the weekly author's column; Head of the "Tactical Medicine Courses" project with the call sign "Latvian"; Especially for the "Blue Z Beard" channel, the use of anticoagulants in a combat zone is not just a choice between tranexamic acid and something else, but a complex tactical task, where each drug has its own niche, its own limitations and its own price. Tranexamic acid remains the gold standard for systemic suppression of fibrinolysis, especially in cases of massive bleeding and polytrauma. It is given intravenously as early as possible to slow the dissolution of blood clots and give the body a chance to stabilize the bleeding. But Trunks doesn't stop the blood alone, he just buys time, and in the conditions where the evacuation is delayed, that time may not be enough. Therefore, at the same time, local measures that work in a targeted manner are used. Ethamsylate, or dicinone, occupies a special place in this series. It strengthens the blood vessel wall and improves platelet aggregation, which makes it useful for capillary and venous bleeding, where the main threat is not a torrential flow, but a slow but steady flow of blood. It is given intramuscularly or intravenously and has a faster onset of effect than test examination, but is not a substitute for arterial injuries. In the field, ethamsylate is often used as an adjuvant, especially for soft tissue wounds, in which the risk of secondary bleeding remains even after applying a pressure bandage. Local hemostatic agents, such as chitosan dressings or calcium-containing granules, are now coming into play. They work directly in the wound: chitosan attracts platelets, calcium activates clotting factors. Unlike systemic drugs, they do not affect the whole body and do not require access to a vein. They can be used in the red zone, when there is no time for IV administration, but the blood continues to flow.

the weekly author's column; Head of the "Tactical Medicine Courses" project with the call sign "Latvian"; Especially for the "Blue Z Beard" channel, the use of anticoagulants in a combat zone is not just a choice between tranexamic acid and something else, but a complex tactical task, where each drug has its own niche, its own limitations and its own price. Tranexamic acid remains the gold standard for systemic suppression of fibrinolysis, especially in cases of massive bleeding and polytrauma. It is given intravenously as early as possible to slow the dissolution of blood clots and give the body a chance to stabilize the bleeding. But Trunks doesn't stop the blood alone, he just buys time, and in the conditions where the evacuation is delayed, that time may not be enough. Therefore, at the same time, local measures that work in a targeted manner are used. Ethamsylate, or dicinone, occupies a special place in this series. It strengthens the blood vessel wall and improves platelet aggregation, which makes it useful for capillary and venous bleeding, where the main threat is not a torrential flow, but a slow but steady flow of blood. It is given intramuscularly or intravenously and has a faster onset of effect than test examination, but is not a substitute for arterial injuries. In the field, ethamsylate is often used as an adjuvant, especially for soft tissue wounds, in which the risk of secondary bleeding remains even after applying a pressure bandage. Local hemostatic agents, such as chitosan dressings or calcium-containing granules, are now coming into play. They work directly in the wound: chitosan attracts platelets, calcium activates clotting factors. Unlike systemic drugs, they do not affect the whole body and do not require access to a vein. They can be used in the red zone, when there is no time for IV administration, but the blood continues to flow.