Tranexamic Acid

TXA is a safe, inexpensive medication that prevents fibrin breakdown.  In traumatic bleeding, it conveys a significant mortality benefit with an impressive NNT for mortality between 7 and 67, depending on injury severity, without apparent serious safety issues.  This benefit is associated with early administration.  TXA should not be given more than three hours after […]

Tranexamic Acid in PPH – WOMAN Trial

Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] […]

Trauma Resuscitation Commandments

The most important step in managing a bleeding trauma patient is surgical source control – most patients with massive hemorrhage need an operation to stay the hemorrhage. The state in which a patient arrives to the operating room or the intensive care unit – alive or near death, cold and coagulopathic or warm and well […]

Trauma research 2014-2015

The headline here is that those with an extradural and fixed dilated pupils have a >50% chance of a good neurological recovery. Please, please, please aggressively manage these patients and avoid any nihilism as a result of this pupilary sign. Give Tranexamic acid to all patients with massive bleeding within 3 hours of trauma Use […]

Tranexamic Acid for Severe Trauma – CRASH-2 Trial

Tranexamic acid (1g given over 10 min (IVI) followed by 1g given over 8h (IVI)) can save 1 in 67 patients with severe trauma CRASH-2: A large multicenter randomised control trial of 20,211 patients (CRASH2) found: The most severely injured patients who received TXA had the highest reduction in mortality. Benefits were greatest for those […]

Cheap solutions: Topical Tranexamic Acid for Nose Bleeds and Oral Bleeds

Recently, there has been a lot of buzz about the use of topical tranexamic acid for epistaxis or oral bleeds on multiple social media platforms. Everyone seems so happy that it works so well, but we thought we would look through the literature and see what the evidence for use of topical tranexamic acid (TXA) is […]

Emergency Medicine Kenya Foundation

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