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Prehospital Tranexamic Acid for Severe Trauma. June 2023
Conclusions: Among adults with major trauma and suspected trauma-induced coagulopathy who were being treated in advanced trauma systems, prehospital administration of tranexamic acid followed by an infusion over 8 hours did not result in a greater number of patients surviving with a favorable functional outcome at 6 months than placebo. (Funded by the Australian National Health and Medical Research Council and others; PATCH-Trauma ClinicalTrials.gov number, NCT02187120.).
Copyright © 2023 Massachusetts Medical Society.
https://pubmed.ncbi.nlm.nih.gov/37314244/
Abstracts
Adv Emerg Nurs J. 2014 Apr;36(2):123-31
Tranexamic Acid for trauma-related hemorrhage.Bailey AM, Baker SN, Weant KA
Abstract:
Trauma-related deaths represent a leading cause of mortality among persons younger than 45 years. A significant percentage of these are secondary to hemorrhage. In trauma, massive and rapid loss of blood creates an imbalance in hemostasis. Mainstays of resuscitation include surgical interventions, restoring intravascular volume, and pharmacologic interventions. Providers continue to search for improved pharmacologic options for achieving hemostasis. Tranexamic acid is an antifibrinolytic and inhibits fibrinolysis by blocking the lysine-binding sites on plasminogen. Tranexamic acid works to stabilize and inhibit the degradation of existing clots. Tranexamic acid has been prospectively proven to reduce mortality in trauma-related hemorrhage. Its use will likely expand into such areas as resuscitation and massive transfusion protocols and the prehospital setting. Therefore, it is critical for emergency medicine providers to be familiar with appropriate use of tranexamic acid in order to maximize efficacy and decrease the potential adverse events.
Tranexamic Acid for trauma-related hemorrhage
AirLink VitaLink able to administer Tranexamic Acid to trauma patients with severe bleeding while en route to the New Hanover Medical Center
By EMS1 Staff
WILMINGTON, N.C. – The AirLink VitaLink critical care transport program has been authorized to administer Tranexamic Acid (TXA) to trauma patients with severe bleeding.
Dr. Heston Lamar, the service's medical director, told WECT that "the body can lose its ability to clot blood after a major traumatic injury. TXA works to restore that process and improve a patient's outcome of survival when used within three hours of the incident."
Since Dec. 1, TXA, prominently known for its use to treat wounded soldiers with severe bleeding, can be administered to patients in transport to the New Hanover Regional Medical Center.
WECT talked to a spokesman for AirLink VitaLink Critical Care Transport team who explained, "Being able to take this drug [TXA] to the bedside and administer it there on scene to get the trauma center and ICU level care started earlier, the better off the patient outcomes are."
TXA has been administered inside the trauma centers for years. Recently, research on using TXA outside of the hospital was conducted.
Lamar said that tests showed TXA was highly effective in stabilizing patients before they arrived at the hospital. In addition to stocking TXA on the critical care helicopters and ambulances, the New Hanover Regional Medical Center is working on approval to stock county EMS ambulances with TXA.
Related: Español
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