Tranexamic Acid

cannonball88

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Good Evening, Folks

I just learned that our agency will be getting a TXA protocol in the next few months. Who else out there has it, have you used it, and can you share any insight as to how well it's worked for you?
 

DesertMedic66

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We have had it for about 2 years. I still have not used it.
 

TXmed

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used it like crazy at a previous agency. Its not something you are gonna be able to tell how well it works. If they got close to meeting the criteria we just gave it. From my understanding (and i may not be up to date) there is no real harm in giving it when its not needed. So we just had a quick trigger with it.
 

Peak

ED/Prehospital Registered Nurse
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We don't carry it in the field, it is part of our MTP for all patients under 30 and based benefit vs risk of thrombotic events in patients over 30. We use it a lot topically for our heme/onc oral bleeds but we give it topically.
 

VFlutter

Flight Nurse
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Like said you will not see any results from it in the time frame you are having these patients. You just have to trust that it will improve your patient's outcome in the long run. The research is pretty good.

We have it and use it. We are also about to get Blood so we will see how that changes things.
 

TransportJockey

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We currently don't carry it because we can't get our local Lvl 1 on board with a plan to continue treatment in the ED. Until that changes, we will continue to not carry it.
 

TXmed

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@TransportJockey That sucks, from my understanding theres not much data supporting the 2nd infusion over 8 hours but it is all about how close to the time of injury it is administered.

If we are talking about the same LVL 1 center, then ive seen them throw our blood products in the trash just to hang NS, so clearly they are the trauma experts.:rolleyes:
 

RocketMedic

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Memorial Hermann? They keep our blood at Woodland MH...
 

TransportJockey

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@TransportJockey That sucks, from my understanding theres not much data supporting the 2nd infusion over 8 hours but it is all about how close to the time of injury it is administered.

If we are talking about the same LVL 1 center, then ive seen them throw our blood products in the trash just to hang NS, so clearly they are the trauma experts.:rolleyes:
The one im talking about is an island all on their own lol
 

RocketMedic

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Prepare the CWIS, it's another modern practice!
 

TransportJockey

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With our head of trauma services I'm not surprised. Hell he gets pissed when we use a trauma bay for a crashing medical or code
 

RocketMedic

Californian, Lost in Texas
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TRAUMAAAA ISS SPEECIIALL!!!!
 

VFlutter

Flight Nurse
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If we are talking about the same LVL 1 center, then ive seen them throw our blood products in the trash just to hang NS, so clearly they are the trauma experts.:rolleyes:

I hate that. Take down our PRBC and toss it then 3 minutes later before we are even done with paperwork "Activate the MTP and get me blood!!!!"
 

Carlos Danger

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Like said you will not see any results from it in the time frame you are having these patients. You just have to trust that it will improve your patient's outcome in the long run. The research is pretty good.

Is it?

Granted it's not something that I keep up with closely because I'm not doing trauma right now, so there may be some supporting data out there that I'm not aware of, but from what I've seen I'm not convinced that it should be used routinely. CRASH-2 definitely had a lot of problems, enough that I don't think it can be considered credible. TXA seems like one of those "next big breakthroughs" that everyone gets excited about for a few years and then it fizzles out when we realize that it doesn't really work that well.
 

Akulahawk

EMT-P/ED RN
Community Leader
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I hate that. Take down our PRBC and toss it then 3 minutes later before we are even done with paperwork "Activate the MTP and get me blood!!!!"
To me it makes more sense to continue infusing the PRBCs and add on FFP and platelets while activating the MTP and getting whole blood...
 

RocketMedic

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To me it makes more sense to continue infusing the PRBCs and add on FFP and platelets while activating the MTP and getting whole blood...

This particular facility strips that away.
 

Akulahawk

EMT-P/ED RN
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This particular facility strips that away.
While I don't know that particular facility, that's the impression I got. Like I said, it just makes sense to me to continue the PRBCs and add on platelets and FFP. That being said, if you know you're going to that particular facility, why not squeeze in the PRBCs as fast as you are allowed so that the patient can at least get some benefit... and then let the facility toss whatever's left (hopefully a nearly empty bag...) while they then deal with their own MTP issues... but hey, that's me. Usually I try to go somewhat slow but if the patient needs it badly enough, I can set the infusion rate much higher than I usually do.
 
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