Hemorrhage remains the leading cause of potentially preventable early trauma-related mortality. To help treat hemorrhage, tranexamic acid (TXA) is an inexpensive option whose optimal use continues to be clarified.

Marilyn J. Heine, MD, FACEP, FACP, clinical assistant professor of medicine at Drexel University College of Medicine in Philadelphia and an emergency physician and hematologist in Dresher, Pennsylvania, will discuss emergency medicine applications of TXA in her presentation.

“Tranexamic acid is being administered in an effort to decrease trauma-associated hemorrhage and/or mortality. The major studies that propelled its use in trauma care were performed predominantly in low/moderate resource countries…Benefit was associated with early TXA infusion. Studies are ongoing to clarify its optimal role in mature trauma systems with a civilian population, such as in the United States,” Dr. Heine said.
Her presentation will address TXA use in hemorrhagic trauma, epistaxis, hyphema, postpartum hemorrhage, and heavy cyclic menstrual bleeding.

The use of oral TXA is approved by the U.S. Food and Drug Administration for heavy cyclic menstrual bleeding, but the other uses that will be described in the presentation are off-label and may not be as well known. “With the evolving literature, many may be unaware of the clinical studies that examine TXA use. It is not included in all EMS systems or part of all institutions’ massive transfusion protocols,” Dr. Heine said.

She also will discuss some considerations for TXA trauma protocols, such as time to definitive trauma care and how to determine patients who may benefit the most from it.