Tranexamic Acid (TXA) || EMS Pharmacology

TXA or tranexamic acid 💉is a medication first discovered in the 1960s by medical professionals searching for a solution for postpartum hemorrhage. After this introduction, massive benefits were reported and it was later adopted into military medicine for traumatic injuries.

Tranexamic acid has become well-known in the 911 EMS setting over the last 10-20 years. It is used to stop life-threatening or severe blood loss 🩸 from traumatic injuries, esophageal varices, postpartum hemorrhage, ectopic pregnancy🤰🏼, epistaxis 👃, etc.

So how does it stop the bleeding? TXA blocks the natural tPA (Tissue Plasminogen Activator) in our own body from breaking down desirable clots needed to stop the bleed. This medication, if used within 3 hours of the injury or when the bleeding commenced, has shown significant chances of improving the patient’s overall outcome and/or chance of survival.

In the hospital setting, TXA may given during routine surgeries to prevent bleeding and for even for angioedema. It may also be prescribed for patients who experience heavy menstrual bleeding. 

There are protocols that advise against TXA in the 911 prehospital setting for a traumatic brain 🧠 bleed due to the lack of access to a CAT scan. Protocols do vary.

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