First, there was Episode 31: TXA for Epistaxis (the Zahed RCT from Tehran), then Episode 40: TXA for Epistaxis, Part Deux (the NoPAC trial), and now Episode 64: TXA for Epistaxis, Part Trois, another Iranian RCT.

 So, we have conflicting evidence, all from RCTs, about whether TXA works for epistaxis. Dr. Jarvis reviews the prior trials and then provides a more detailed analysis of the new evidence. He then discusses how he handles conflicting evidence. 

Citation: Hosseinialhashemi M, Jahangiri R, Faramarzi A, et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Annals of Emergency Medicine. 2022;80(3):182-188. doi:10.1016/j.annemergmed.2022.04.010