Trauma systems and emergency medical services: The missing link for tranexamic acid utilization in major trauma

Tallon, John M.

doi:10.1017/cem.2018.22

Cited by 1 publication

(3 citation statements)

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“…Among a sample of eligible patients assessed in this study, only 35% of major trauma patients in the EMS phase of care received a dose of TXA. With increasing evidence supporting the use of TXA in trauma patients, it is paramount that EMS administration rates improve [2][3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…With emerging evidence of TXA's time-sensitive benefits, paramedics have the opportunity to administer TXA before arrival to the hospital, especially in remote communities. In turn, TXA can be administered sooner within the 180-min window while allowing hospitals to concentrate on other aspects of care [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…BC Emergency Health Services (BC EHS) is the sole pan-provincial provider of EMS in British Columbia (BC). In 2014, BC EHS added TXA to the scope of practice of several specific paramedic certification levels [1,6,7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing the clinical utilization of tranexamic acid by paramedics for patients with major trauma (ACUTE)

Wong

Mabasa

et al. 2021

Can J Emerg Med

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Objectives This study aimed to characterize the clinical utilization of tranexamic acid (TXA) by paramedics in British Columbia (BC) for acute major trauma and to quantify the percentage of patients who received TXA among those who met the indications for administration. Methods A quality assurance review of eligible trauma patients across the province was performed using a convenience sample. Trauma patients between April 1, 2016 and March 31, 2017 with suspected or actual hemorrhage were selected if they met inclusion criteria (systolic blood pressure < 90 mm Hg ± heart rate > 120 beats per minute) and exclusion criteria (age < 16 years, injuries exclusively to the extremities). Results 35 of the 100 eligible patients assessed in this review received a dose of TXA from paramedics. All 35 of the patients received TXA within 180 min of injury regardless of their original location of injury in BC (mean: 50 min; range: 15-140 min). Conclusions 35% of eligible patients identified in this study received TXA, which is an improvement over rates cited by previous Canadian literature. With further education opportunities for paramedics in BC and other EMS systems, there is potential to continue improving pre-hospital TXA administration rates. KeywordsTranexamic acid • Paramedic • Pre-hospital • Trauma • Emergency medicine • Emergency medical service Résumé Objectifs Cette étude visait à caractériser l'utilisation clinique de l'acide tranexamique (TXA) par les ambulanciers paramédicaux de la Colombie-Britannique pour les traumatismes aigus majeurs et à quantifier le pourcentage de patients qui ont reçu du TXA parmi ceux qui répondaient aux indications d'administration. Méthodes Un examen de l'assurance qualité des patients traumatisés admissibles dans toute la province a été effectué à l'aide d'un échantillon de commodité. Les patients traumatisés entre le 1er avril 2016 et le 31 mars 2017 présentant une hémorragie suspectée ou réelle ont été sélectionnés s'ils répondaient aux critères d'inclusion (pression artérielle systolique < 90 mm Hg ± fréquence cardiaque > 120 battements par minute) et aux critères d'exclusion (âge < 16 ans, blessures exclusivement aux extrémités).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%