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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Tranexamic Acid in Trauma.

Whitney J Barrett1, Kevin A Kaucher2, Ross E Orpet3

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|August 22, 2025
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Summary
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Tranexamic acid (TXA) use in prehospital trauma care is debated. New evidence supports updated guidance for emergency medical services (EMS) on administering intravenous TXA to injured patients.

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Area of Science:

  • Emergency Medicine
  • Trauma Care
  • Pharmacology

Background:

  • Prehospital use of tranexamic acid (TXA) has increased significantly in the last decade.
  • Contradictory evidence exists regarding the benefits of widespread TXA administration in trauma patients.
  • Previous guidance on prehospital TXA for injured patients was issued in 2016.

Purpose of the Study:

  • To provide updated, evidence-based recommendations for the prehospital use of intravenous TXA in injured patients.
  • To address the evolving research landscape concerning TXA in emergency medical services (EMS).

Main Methods:

  • A structured literature review was conducted to synthesize recent research findings.
  • Recommendations were developed based on the evidence summarized in an accompanying resource document.

Main Results:

  • The review identified new research investigating patient outcomes following prehospital TXA administration.
  • The findings informed the development of updated clinical guidance.

Conclusions:

  • The National Association of EMS Physicians, American College of Surgeons Committee on Trauma, and American College of Emergency Physicians provide updated recommendations.
  • These recommendations guide the appropriate use of intravenous TXA in the prehospital setting for injured patients.