Compliance of trauma team leaders with administering tranexamic acid for significant hemorrhage

Abstract EN

Hyperfibrinolysis forms an integral component of the acute coagulopathy of trauma trauma.

This process can be blocked by antifibrinolytic drugs such as tranexamic acid (TXA).

Objective: To evaluate the current compliance rate of trauma team leaders (TTL) of administering TXA for eligible patients.

Design: A Retrospective Study.

Setting: Bahrain Defence Force Hospital, Bahrain.

Method: A retrospective clinical study was performed from October 2016 to March 2017.

The patients data were retrieved from the trauma registry and only those ≥18 years old were included.

Sixty-one patients were seen in the trauma bay.

The compliance rate of administering TXA was documented.

The inclusion criteria were as follows: adult trauma patients (>18 years) with evidence of ongoing hemorrhage on arrival to the trauma bay suggested by: systolic blood pressure (SBP) ≤ 90, heart rate (HR) ≥ 110, and patients transfused with 1 unit of O-PRBC (packed red blood cells).

The exclusion criteria included age ≤18, hypersensitivity to TXA or any of its excipients, and frank hematuria.

Result: Twenty-six patients out of 58 (44.8%) had met the inclusion criteria and were supposed to receive TXA according to hospital guidelines.

Only 8 (30.7%) received TXA as part of their initial resuscitation in the trauma bay.

Conclusion: A low compliance rate was observed.

Current efforts can be directed towards adjusting guidelines and reinforcing seminars to improve adherence.

Other interventions can be implemented in the long-term.