Volume : 12, Issue : 10, October – 2025
Title:
OPTIMIZING PREHOSPITAL HEMORRHAGE CONTROL: A REVIEW OF TRANEXAMIC ACID USE IN EMERGENCY MEDICAL SERVICES
Authors :
Ali Hulayyil Ayash Alanzai , Issa Thani Shafi Alshammari , Abdulmajeed Khulaif Awad Alshammari , Muneer Mohammed Alhashim, Faisal Turki Olyan Alharbi , Mohammed Eid Fanoon Alazmi , Eid Hamoud Alrashed , Bandar Faleh AlDossary
Abstract :
Uncontrolled hemorrhage remains one of the leading causes of preventable death in trauma patients, particularly in the critical prehospital phase of care. Tranexamic acid (TXA), an antifibrinolytic agent, has emerged as a simple, cost-effective intervention to improve survival by reducing trauma-related bleeding. Landmark studies such as the CRASH-2 trial demonstrated significant reductions in mortality when TXA was administered early, with subsequent trials including MATTERs, STAAMP, and PATCH-Trauma expanding the evidence base to both military and civilian prehospital settings. The rationale for prehospital TXA administration lies in its time-sensitive mechanism, where early inhibition of fibrinolysis during the “golden hour” is most effective. Despite promising outcomes, implementation in emergency medical services (EMS) faces challenges, including variable protocols, dosing uncertainties, logistic barriers, and concerns regarding thromboembolic events. This review critically examines the current evidence, clinical outcomes, and barriers associated with prehospital TXA use, while exploring strategies for optimizing its role in EMS. By integrating TXA into standardized prehospital trauma protocols, supported by provider training and technological decision-support systems, EMS can further reduce hemorrhage-related mortality and enhance patient survival outcomes worldwide.
Keywords: Tranexamic Acid; Prehospital Care; Trauma; Hemorrhage Control; Emergency Medical Services; Patient Outcomes; CRASH-2; MATTERs; EMS Protocols
Cite This Article:
Please cite this article in press Ali Hulayyil Ayash Alanzai et al., Optimizing Prehospital Hemorrhage Control: A Review Of Tranexamic Acid Use In Emergency Medical Services, Indo Am. J. P. Sci, 2025; 12(10).
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