Is TXA a lifesaving drug that’s too cheap
to bother using?
By Matt Bivens, MD
Male found sitting upright in the back of the bar holding his hand to his neck and friends holding
bandages to his abdomen … immediately secured to stretcher and ambulance due to multiple significant wounds and unruly / unsafe environment … [Patient] stated that he and another male had an
argument and he was stabbed multiple times by a knife …
This is how the run sheet from an early morning bar fight describes the first patient to receive a lifesaving medi-
cation from Massachusetts paramedics under
a new trauma protocol. The drug is tranexamic
acid (TXA), and it currently costs EMS agen-
cies about $30 a dose.
TXA is a generic drug that’s been around
for decades, and in fact is sold over-the-
counter in Europe and Japan for heavy menses.
Delivered via IV to trauma patients, it’s been
found to be lifesaving, with no dangerous side
effects. It has the potential to save thousands
of lives a year across the United States. And
yet, very few EMS systems have incorporated
it into their protocols.
THE MAGIC OF TXA
TXA helps prevent the body from prematurely breaking down clots. It doesn’t make
new clots, just protects existing clots as the
body forms them.
This isn’t a trivial distinction: There have
been expensive pro-clotting agents brought
out in recent years that, despite initial hype,
turned out to have dangerous side-effects.