Remember this article about giving tranexamic acid for trauma? It certainly crashed (ha!) the party at the time and is changed trauma practice. This follow up review now in the Lancet shows us again that the earlier you give it, the better – but timing is important…
Treatment within the first hour improved mortality rates – a relative risk of 0.68. Treating within the 1-3 hour window also improved things, but not quite as much. Giving it after 3 hours (after injury that is, not admission) was more interesting – it actually seemed to increase the risk of death.
Interesting stuff – if you’ve got a bleeding trauma patient, give the tranexamic acid as soon as you can – and if they come after 3 hours, you may have to rethink whether you give it at all. Check out the article in the Lancet here.
Oh, and talking about car accidents – check out this amazing video doing the rounds on YouTube: