Prehospital tranexamic acid for trauma victims.

Area of Science:

• Emergency Medicine
• Trauma Care
• Pharmacology

Background:

• A public inquiry highlighted the need for rapid tranexamic acid administration in trauma.
• UK paramedics are authorized for pre-hospital intramuscular tranexamic acid, but Japan lags despite the drug's origin.
• Instances of pre-hospital death from traumatic bleeding in Japan underscore the need for improved emergency care.

Purpose of the Study:

• To summarize the current evidence on tranexamic acid use in patients with traumatic bleeding.
• To specifically review new evidence supporting the intramuscular route of tranexamic acid administration.
• To inform the discussion on authorizing pre-hospital tranexamic acid administration in Japan.

Main Methods:

• Review of existing studies and clinical trials on tranexamic acid in trauma.
• Inclusion of recent evidence focusing on the intramuscular administration route.
• Synthesis of data relevant to pre-hospital settings.

Main Results:

• Evidence supports the timely administration of tranexamic acid to reduce mortality in trauma.
• The intramuscular route offers a viable alternative for pre-hospital administration.
• UK's authorization of paramedics using intramuscular tranexamic acid serves as a potential model.

Conclusions:

• Pre-hospital tranexamic acid, particularly via the intramuscular route, is crucial for managing traumatic bleeding.
• Further consideration is needed for authorizing emergency life-saving technicians in Japan to administer tranexamic acid.
• Implementing pre-hospital tranexamic acid can improve outcomes for critically injured patients.