Core EM - Emergency Medicine Podcast

Episode 77.0 – Give TXA Now!

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This week the podcast features a talk Jenny Beck-Esmay gave at the 11th All NYC EM Conference entitled "Give TXA Now!"

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Tags: All NYC EM, CRASH-2, Massive Transfusion Protocol, MATTERS, Trauma, TXA
Show Notes

Take Home Points

  1. Giving TXA provides a significant mortality benefit to the any trauma patient requiring massive transfusion with an NNT = 7 for mortality
  2. TXA must be given early. Give within 1 hour of injury if possible but the benefit remains up to 3 hours out
  3. TXA administration: 1 gram as a bolus followed by 1 gram over the next 8 hours

    4. Show Notes

    Intensive Care Network: Karim Brohi on TXA in Trauma

    EMCrit: Podcast 67 – Tranexamic Acid (TXA)

    Core EM: CRASH-2 Tranexamic Acid in Major Trauma

    References

    CRASH-2 trial collaborators. Effects of tanexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a ransomised placebo-controlled trial. Lancet 2010; 376: 23-32. PMID: 20554319

    Guerriero C et al. Cost-effectiveness analysis of administering tranexamic acid to bleeding trauma patients using evidence from the CRASH-2 trial. PLoS One 2011; 6(5): e18987. PMID: 21559279

    Ker K et al. Avoidable mortality from giving tranexamic acid to bleeding trauma patients: an estimation based on WHO mortality data, a systematic literature review and data from the CRASH-2 trial. BMC Emerg Med 2012; 12:3. PMID: 22380715

    Morrison JJ et al. Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) Study. Arch Surg 2012; 147 (2): 113-9. PMID: 22006852


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