Tranexamic acid

[medicmole]

Our service has added TXA.

Just wondering how many other services are using it and if it is used very often or another one of those drugs that sits in the kit until it expires.

Edited November 18, 2014 by medicmole

[triemal04]

We don't carry it (yet). I would think that how often it gets used will be more a function of how often you see more serious traumatic injuries; if it's not common then you probably won't be using it that much. If you work in the knife and gun club...probably use it more.

[ERDoc]

It's also being used in the hospital for dysfunctional uterine bleeding and postpartum hemorrhage.

[BushyFromOz]

Its being trialled here (either soon or about to start) prehospitally. I think the issue with it is that CRASH-2 (i tihnk that was the trial) less than 400 patients were from 1st world trauma systems, with most ebing 3rd world. So there may no be a significant difference for patients in 1st world systems provided they have a relatively short time to hospital, having said that, Australia is a big country, im sure it has use in the more remote areas of australia

https://www.mja.com.au/journal/2013/199/5/trauma-and-tranexamic-acid som info, and some of these guys are involved in the upcoming PATCH trial here

Edited November 19, 2014 by BushyFromOz

[Timmy]

I’ve used it twice in hospital, once for an obstetric emergency and the other was last weekend I had a 22 year old cystic fibrosis patient who had a large hematemesis event with EBL 600 to 700ml, initially hemodynamically unstable with ambulance but after fluid challenge and tranexamic acid he recovered well and maintained for 2 hour transport to specialist care.

Haven’t had the chance to use it in trauma patient’s yet.

[mobey]

Anyone heard of putting TXA on a gauze and cramming it into an uncontrolled hemmorage?

Heard of one case in the #FOAM world used on a uncontrolled hemorrhage in the oral cavity, but cant find the reference.

Definatly gonna call med control to try for orders when I get the opportunity

[ERDoc]

http://aop.sagepub.com/content/46/1/97.short

Given me a call Mobey, I'll give you orders for it. EMS here doesn't carry it,

[triemal04]

Anyone heard of putting TXA on a gauze and cramming it into an uncontrolled hemmorage?

Heard of one case in the #FOAM world used on a uncontrolled hemorrhage in the oral cavity, but cant find the reference.

Definatly gonna call med control to try for orders when I get the opportunity

I think Broome Doc's talked about using it for uncontrolled nosebleeds. May have been someone else though.

[rock_shoes]

As of November 1, 2014 you can add BCAS to the list of services carrying and using TXA for major trauma patients. Funny how things work. As soon as it came out on car my trauma patients seem to have dried up. I sure could have used it in September/October.

[hertzvanrental]

We have it here in the UK. My service was one of the first. Used it quite a bit. We obviously use it in Trauma but is also now indicated for post partum haemorrhage (we've had syntometrine removed and are not getting misoprostol), internal bleeding etc. In fact used it 2 nights ago. Eastern European guy was beaten by 6 guys and left for dead. Had lost about 600ml on the floor from a mouth injury. Had to suction him, apply constant direct pressure en route to the ER/AE. BP was down. Treated with fluid and 1g IV TXA.