EMS World

MAR 2015

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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TRAUMA CARE I n the United States, trauma is the leading cause of death for patients under 45 and the fourth- leading cause of death for all ages. The CDC has reported that more than 140,000 patients die each year from traumatic injuries and 80,000 are permanently disabled. 1,2,12 The annual number of U.S. in-hospital deaths due to bleeding is estimated to be 12,489. 1,2 Rapid assessment and proper treat- ment of trauma patients begins in the prehospital environment with the arrival of trained emergency medical personnel and is essential in the presence of life-threatening injuries. 8 Tranexamic acid (TXA) was originally developed for the treatment of hemophilia and to reduce bleed- ing in patients undergoing oral surgery. It has been shown effective as a preoperative drug that minimizes the need for large amounts of whole blood during general surgery procedures. 4–6 TXA is now being used to treat severely injured trauma patients who have or are at risk for severe hemorrhage. 1–4,6,7,10,11 Tranexamic acid is produced by Pfizer Injectables and distributed by the Pharmacia & Upjohn Com- pany as Cyklokapron. TXA is a synthetic amino acid (lysine) that blocks plasminogen from being converted to the enzyme plasmin. Plasmin works to break down already-formed blood clots in the human body by attacking and breaking down fibrin, destroying clots in a process known as fibrinolysis. 1 TXA is widely used by hospitals in Europe and other countries for severely injured trauma patients. 1–4,6,7,10,11 TXA recently has been added to the trauma resuscitation protocols for U.S. Special Operations medics, role Implementing tranexamic acid for trauma patients will result in decreased mortality By Jon E. Thomas, BS, ATP, NREMT-P Photos by Kevin Collopy 24 MARCH 2015 | EMSWORLD.com

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