A Cross-sectional Survey on the Use of Tranexamic Acid in the Pre-hospital Setting

Tranexamic Acid (TXA), an anti- fibrinolytic, has been used in military trauma cases and civilian Emergency Departments for several years. This study aims to evaluate protocols for the administration of TXA across Emergency Medical Services (EMS) regions in the United States.

An anonymous survey was distributed by the National Association of Emergency Medical Technicians (NAEMT) to its members.

A total of 264 eligible responses were received. Respondents included paramedics (62.5%), emergency medical technicians (EMTs) (9%), critical care paramedics (11%), and other health care professionals (19%). The majority of protocols included criteria for blood pressure (67%), heart rate (53%), and age (66%). Notable variations included TXA dilution and indications for traumatic brain injury.

TXA has been widely implemented in EMS protocols since the CRASH (Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage) trials. However, there remains significant variations in indications and dose concentrations.