Prehospital Administration of Tranexamic Acid in Patients with Head Injury

This randomized, controlled trial did not demonstrate a statistically significant effect on neurologically favorable survival.

The CRASH-3 trial touted reduced mortality in patients with mild-to-moderate traumatic brain injury (TBI) who received tranexamic acid (TXA; NEJM JW Emerg Med Dec 2019 and Lancet 2019; 394:1713). TXA is thought to be most effective when administered right after injury. To assess outcomes with prehospital administration of TXA, researchers randomized 1063 patients with TBI and Glasgow Coma Scale scores of 3 to 12 to one of three interventions: a 1-g TXA bolus prehospital followed by a 1-g TXA infusion in-hospital; a 2-g TXA bolus prehospital and a placebo infusion in-hospital; or a placebo bolus prehospital and a placebo infusion in-hospital.

The initial bolus was started a median of 40 to 43 minutes after injury. Of 966 patients included in …

Reviewing Author

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Prehospital Administration of Tranexamic Acid in Patients with Head Injury

Topics

Reviewing Author