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Tranexamic acid in major trauma: implementation and evaluation across South West England

Paudyal, Priyamvada; Smith, Jason; Robinson, Maria; South, Adrian; Higginson, Ian; Reuben, Adam; Shaffee, Julian; Black, Sarah; Logan, Stuart

European Journal of Emergency Medicine: February 2017 - Volume 24 - Issue 1 - p 44–48
doi: 10.1097/MEJ.0000000000000323
ORIGINAL ARTICLES
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Objective To carry out a prospective evaluation of tranexamic acid (TXA) use in trauma patients.

Patients and methods TXA was introduced to all emergency ambulances and emergency departments in the South West, UK, on 1 December 2011. We carried out a prospective evaluation of TXA use in trauma patients in the South West Peninsula between December 2011 and December 2012. We collected prehospital and hospital data on TXA administration using the Trauma Audit Research Network database. Data on prehospital administration of TXA were cross-checked with the South Western Ambulance Service Trust. Data were analysed using SPSS (version 20).

Results Altogether, 82 patients were administered TXA during the study period. The median age of the patients was 49 years (IQR 30, 66), and 72% were men. One-third of the patients arrived at hospital by air ambulance. During the first 3 months, administration of TXA was limited to one patient each month receiving the drug. However, an upward trend was observed after June until October 2012, with the increment being more than 10 fold in July, September and October 2012.

Conclusion This is the first study to evaluate the use of TXA in civilian practice in the UK. Our study shows that ambulance service personnel and emergency departments can effectively administer TXA.

aNational Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula (NIHR PenCLAHRC)

bSouth Western Ambulance Service NHS Foundation Trust (SWAST)

cEmergency Department, Royal Devon and Exeter NHS Foundation Trust, Exeter

dBrighton and Sussex Medical School, Division of Primary Care and Public Health, Brighton

eAcademic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Medical Directorate, Joint Medical Command, Birmingham, UK

fEmergency Department, Derriford Hospital, Plymouth, UK

Correspondence to Priyamvada Paudyal, PhD, Brighton and Sussex Medical School, Division of Primary Care and Public Health, Brighton BN1 9PH, UK Tel: +44 1273 644548; fax: +44 1273 644440; e-mail: p.paudyal@bsms.ac.uk

Received February 13, 2015

Accepted August 6, 2015

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