AirLIFE adds drug to stop blood loss from injury

A drug shown to slow massive bleeding and save lives if given early enough is now aboard San Antonio AirLIFE helicopters for use in seriously injured patients.

Tranexamic acid, or TXA, aids in clotting. It’s been around for many years and used for hemophilia, dental procedures and other conditions. And while it’s also been used to treat bleeding from serious injuries in other parts of the world, interest in this country has grown with the completion of two studies outside the United States — one of those involving some local military trauma surgeons and Coalition Forces in Afghanistan.

“This medication is relatively inexpensive, and can be easily administered by intravenous administration and then an infusion,” said Dr. Craig Manifold, medical director of San Antonio AirLIFE, a jointly owned service of University Health System and the Baptist Health System. “It has the most benefit if administered within three hours of the time of injury.  We hope to affect more patients by moving this medication into the pre-hospital environment.”

Manifold said that the drug has been shown to reduce the risk of dying from traumatic blood loss by more than 30 percent if given within an hour of injury. It reduces the risk by 20 percent if given one to three hours after injury.

In recent years, the U.S. military debated using TXA to treat wounded soldiers. The problem was that the best evidence of its effectiveness came from a large, international study involving civilians in mostly developing countries. It didn’t seem applicable to the military’s needs.

But the British were using it in Afghanistan on badly wounded Coalition troops — some of them American. Researchers from the U.S. Institute of Surgical Research at Joint Base Fort Sam Houston in San Antonio went back to look at the results, in collaboration with their British counterparts. That study, called MATTERs — for Military Application of Tranexamic Acid in Trauma Emergency Resuscitation — also found a significant survival benefit.

“Learning from our experiences is one of the most import things we can do in war and medicine,” said Dr. Brian Eastridge, professor of surgery at the UT Health Science Center San Antonio and trauma medical director at University Hospital. “Data from the battlefield demonstrated a decrease in loss of life — especially in those with massive hemorrhage from their wounds.”

Eastridge, a combat veteran with five battlefield deployments, added that using TXA to treat injured patients with massive bleeding “should be one of those critical medical lessons translated from the battlefield to improve trauma care in our community.”

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