Tranexamic Acid (TXA) has gained a significant amount of attention over the last few years as multiple studies have shown it's utility in decreasing haemorrhage and associated mortality. It has become part of major trauma guidelines, post part haemorrhage protocols and many have adopted it to the management of traumatic brain injury. The findings have been very similar across a spectrum of haemorrhage disease processes and from this further interest in expanding TXA's application to pretty much anything that bleeds. Time from onset of the bleeding has been shown to be important, with it's effect decreasing from time of onset to its administration.
Gastro-intestinal bleeding is a significant cause of morbidity and mortality. Previous meta-analyses have shown favourable outcomes for TXA in GI bleeds and many have already adopted TXA into this area of practice, although guidance from NICE does not yet recommend it.
HALT-IT is a multi centre, international, randomised double blind controlled trial of near 12,000 patients that has just been published in the Lancet. The study was a huge piece of work and looks to definitively answer the question of whether we should be giving TXA to patients with life threatening GI bleeds. In this podcast we run through the ins and outs of the paper ad are lucky enough to speak to the lead author Ian Roberts about the findings, some of the intricacies of the trial and what the results mean for practice.
Simon, Rob & James
Welcome back to June’s Papers Podcast!
Traditionally when you’re taught about working a patient up for a potential diagnosis you’ll find a list of signs, symptoms and tests that you need to perform in order to obtain your diagnosis. What that teaching doesn’t tell you is how important each of those aspects is and this month we take a deeper look at this for pneumonia. We look two papers, one focussing on the clinical findings both in signs and symptoms and then a further paper on the importance of biomarker in the diagnosis.
We also have a look at a paper which focusses on decreasing time on scene for prehospital patients and the potential benefit of regular time prompts, an idea that may be applicable irrespective of your place and role of work.
We’d love to hear any thought or comments you have either on the website or via twitter @TheResusRoom.
Simon & Rob