Related Experiment Video
Updated: Jul 26, 2025

A Saline/Bipolar Radiofrequency Energy Device As an Adjunct for Hemostasis in Solid Organ Injury/Trauma
Published on: July 28, 2020
Prehospital Tranexamic Acid for Severe Trauma
, Russell L Gruen1, Biswadev Mitra1
1From the College of Health and Medicine, Australian National University (R.L.G.), Canberra Health Services (R.L.G.), and Joint Health Command, Australian Defence Force (M.C.R.), Canberra, ACT, the Emergency and Trauma Centre (B.M., P.A.C.) and the Departments of Anaesthesiology and Perioperative Medicine (P.S.M.) and Intensive Care (S.A.B., D.C.G.), Alfred Hospital, the Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine (D.C.G., L.J.M., S.J.N., T.T., P.J.Y.), the School of Public Health and Preventive Medicine (B.M., S.A.B., C.J.M., P.A.C., A.B.F., C.A.M., V.P.), the Australian Centre for Blood Diseases (R.L.M.), and the Central Clinical School (P.S.M.), Monash University, Ambulance Victoria (S.A.B.), and the Department of Critical Care, University of Melbourne (P.J.Y.), Melbourne, Aeromedical Operations, NSW Ambulance, Trauma Service, Royal North Shore Hospital, and Sydney Medical School, University of Sydney, Sydney (B.B.), MedSTAR Emergency Medical Retrieval Services, South Australian Ambulance Service (S.M.M.), and the Emergency Department, Royal Adelaide Hospital (S.M.M.), Adelaide, SA, and Queensland Ambulance Service (S.R.) and the Faculty of Medicine, University of Queensland (M.C.R.), Brisbane - all in Australia; Te Toka Tumai Auckland City Hospital (C.J.M.), Hato Hone St. John, Mt. Wellington (B.D.), and the Department of Paramedicine, Faculty of Health and Environmental Sciences, Auckland University of Technology (B.D., A.H.S.), Auckland, and Medical Research Institute of New Zealand (C.J.M., S.H., P.J.Y.), Wellington Free Ambulance (A.H.S.), and the Intensive Care Unit, Wellington Hospital (P.J.Y.), Wellington - all in New Zealand; Cologne-Merheim Medical Center, Department of Traumatology, Orthopedic Surgery, and Sports Medicine, and the Institute for Research in Operative Medicine, Witten-Herdecke University - both in Cologne, Germany (M.M.).
Prehospital tranexamic acid did not improve survival with good function in major trauma patients. This study found no significant difference in favorable outcomes at six months compared to placebo.
Area of Science:
- Trauma Care
- Emergency Medicine
- Coagulation Disorders
Background:
- Major trauma can lead to trauma-induced coagulopathy.
- The effectiveness of prehospital tranexamic acid in improving outcomes for these patients is uncertain.
Purpose of the Study:
- To determine if prehospital tranexamic acid administration improves survival with favorable functional outcomes in major trauma patients.
- To assess the impact of tranexamic acid on mortality and functional recovery.
Main Methods:
- Randomized controlled trial involving adults with major trauma at risk for coagulopathy.
- Intervention group received tranexamic acid (1g bolus, then 1g over 8 hours); control group received placebo.
- Primary outcome: survival with favorable functional outcome (Glasgow Outcome Scale-Extended level ≥5) at 6 months.
Main Results:
- No significant difference in favorable functional outcomes at 6 months between tranexamic acid and placebo groups (53.7% vs. 53.5%).
- Tranexamic acid group showed a trend towards reduced mortality at 28 days (17.3% vs. 21.8%) and 6 months (19.0% vs. 22.9%), though not statistically significant.
- No meaningful difference in serious adverse events between groups.
Conclusions:
- Prehospital tranexamic acid, followed by an 8-hour infusion, did not improve survival with favorable functional outcomes in major trauma patients.
- The study did not demonstrate a benefit of tranexamic acid for this specific patient population and treatment protocol.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Venous Thrombosis IV: Nursing Management
Introduction to Hemostasis
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Acute Coronary Syndrome IV: Interprofessional Care

