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dc.contributor.authorMarsden, MERen_US
dc.contributor.authorRossetto, Aen_US
dc.contributor.authorDuffield, CABen_US
dc.contributor.authorWoolley, TGDen_US
dc.contributor.authorBuxton, WPen_US
dc.contributor.authorSteynberg, Sen_US
dc.contributor.authorBagga, Ren_US
dc.contributor.authorTai, NRMen_US
dc.date.accessioned2019-09-06T16:43:37Z
dc.date.available2019-05-02en_US
dc.date.issued2019-07en_US
dc.identifier.urihttps://qmro.qmul.ac.uk/xmlui/handle/123456789/59565
dc.description.abstractINTRODUCTION: Tranexamic acid (TXA) reduces bleeding and mortality. Recent trials have demonstrated improved survival with shorter intervals to TXA administration. The aims of this service evaluation were to assess the interval from injury to TXA administration and describe the characteristics of patients who received TXA pre-hospital and in-hospital. METHODS: We reviewed Trauma and Audit Research Network records and local trauma registries to identify patients of any age that received TXA at all London Major Trauma Centres and Queen's Medical Centre, Nottingham, during 2017. We used the 2016 NICE Guidelines (NG39) which state that TXA should be given within 3 hours of injury. RESULTS: We identified 1018 patients who received TXA, of whom 661 (65%) had sufficient data to assess the time from injury to TXA administration. The median interval was 74 min (IQR: 47-116). 92% of patients received TXA within 3 hours from injury, and 59% within 1 hour. Half of the patients (54%) received prehospital TXA. The median time to TXA administration when given prehospital was 51 min (IQR: 39-72), and 112 min (IQR: 84-160) if given in-hospital (p<0.001). In-hospital TXA patients had less haemodynamic derangement and lower base deficit on admission compared with patients given prehospital TXA. CONCLUSION: Prehospital administration of TXA is associated with a shorter interval from injury to drug delivery. Identifying a proportion of patients at risk of haemorrhage remains a challenge. However, further reinforcement is needed to empower pre-hospital clinicians to administer TXA to trauma patients without overt signs of shock.en_US
dc.description.sponsorshipFondazione Cassa Rurale di Trento, Italy.en_US
dc.format.extent395 - 400en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofEmerg Med Jen_US
dc.rightsThis article has been accepted for publication in Emergency Medicine Journal, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/emermed-2018-208118. “Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) http://creativecommons.org BMJ Authors Self-Archiving Policy, September 2018 https://creativecommons.org/licenses/by-nc/4.0/
dc.subjectfibrinolysisen_US
dc.subjecthaemorrhageen_US
dc.subjectmultiple traumaen_US
dc.subjecttranexamic aciden_US
dc.subjecttrauma centresen_US
dc.titlePrehospital tranexamic acid shortens the interval to administration by half in Major Trauma Networks: a service evaluation.en_US
dc.typeArticle
dc.rights.holder(c) 2019 The Author(s).
dc.identifier.doi10.1136/emermed-2018-208118en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/31217180en_US
pubs.issue7en_US
pubs.notesNot knownen_US
pubs.publication-statusPublisheden_US
pubs.volume36en_US
dcterms.dateAccepted2019-05-02en_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.funder.projecteea3a0cf-7193-42f5-a8db-415e0e874d28en_US


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