Case Series on 2g Tranexamic Acid Flush From the 75th Ranger Regiment Casualty Database

Androski, Christopher; Bianchi, William; Robinson, Douglas L.; Zarow, Gregory J.; Moore, Christopher A.; Deaton, Travis G; Drew, Brendon; González, Sergio; Knight, Ryan M

doi:10.55460/cg6s-n11m

Cited by 4 publications

(1 citation statement)

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“…The beneficial effect of TXA administration very early in prehospital management, especially in the first hour, in the trauma patient has been known since the results of the CRASH-2 study 21. In their recent study, Guyette et al 21 found a reduction in the mortality rate in the group of patients who received TXA in the first hour following trauma but also in patients who received 2 g of intravenous TXA over 10 min compared with those who received only 1 g. The latest military recommendations, both in the USA in 202022 and France in 2021,5 already recommend the administration of 2 g of TXA to the war-wounded soldier with a possibly active haemorrhage. The administration of TXA at this dosage does not seem to present any particular adverse effects at the time of administration23 24 and could be considered in the civilian environment soon.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of tranexamic acid administration in French war-wounded between October 2016 and September 2020

Pinna

Aigle

et al. 2023

BMJ Mil Health

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IntroductionSince 2013, the French Army Health Service, in agreement with international experts, has recommended the administration of 1 g of tranexamic acid (TXA) in trauma patients in haemorrhagic shock or at risk of bleeding within 3 hours of the trauma.MethodsThe aim of this analysis was to describe the administration of TXA in French military personnel wounded during military operations in the Sahelo-Sahelian band between October 2016 and September 2020. Data were collected from forward health records and hospital data from the French hospital where the casualty was finally evacuated. Underuse of TXA was defined as the lack of administration in casualties who had received a blood transfusion with one or more of red blood cells, low-titre whole blood or French lyophilised plasma within the first 24 hours of injury and overuse as its administration in the non-transfused casualty.ResultsOf the 76 patients included, 75 were men with an average age of 28 years. Five patients died during their management. 19 patients received TXA (25%) and 16 patients were transfused (21%). Underuse of TXA occurred in 3 of the 16 patients (18.8%) transfused. Overuse occurred in 6 of 60 (10%) non-transfused patients.ConclusionThe analysis found an important underuse of TXA (almost 20%) and highlighted the need for optimising the prehospital clinical practice guidelines to aid prehospital medical practitioners more accurately in administering TXA to casualties that will require blood products.

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Section: Discussionmentioning

confidence: 99%