Rural trauma patients cannot wait: tranexamic Acid administration by helicopter emergency medical services

Tranexamic acid (TXA) administration has been shown to reduce mortality in bleeding trauma patients if given in the hospital within 3 hours of injury. Its use has been theorized to be of benefit in the prehospital environment. This study evaluates the timing of TXA administration in a critical care helicopter emergency medical service (HEMS) versus that of the destination trauma hospital.

We performed a retrospective chart review of consecutive trauma patients who were given TXA during HEMS transfer. The time of injury to HEMS arrival, TXA administration, and hospital arrival was collected.

Twenty complete records were identified in which TXA was administered by HEMS: 11 scene calls and 9 interfacility transfers. The median time in minutes from the time of injury to HEMS arrival, TXA administration, and receiving hospital arrival was 90, 114, and 171, respectively, for scene calls and 134, 173, and 224, respectively, for interfacility transfers.

TXA must be administered before arrival at a trauma hospital to meet the recommendation of administration within 3 hours of injury for all patients transferred between facilities and for many patients transported from a trauma scene.