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TXA.

What if there was a drug that would stop bleeding early? What if that drug had been shown to be effective? What would it take for you to use the drug? Over 90 percent of hospitals have some kind of massive transfusion protocol, but only about two thirds of those hospitals carry Tranexamic acid, or TXA.

What does TXA do? Specifically, it serves an analog to lysine and binds to four or five lysine receptors sites on plasminogen or plasmin. That’s a lot of biochemistry. Essentially, what all that does is stops the breakdown of fibrin, which allows clots to form and stay formed longer than they usually would.

But is TXA new? in 2013, JEMS put out an article discussing the potential benefits and risks of TXA. In 2017, BMJ put out an article discussing the state of the science of TXA. Later in 2017, a study from Japan in the British Journal of Surgery showed the effectiveness of it. But it’s important to note that this drug, despite the available evidence that has come out for the past 4 years, is not new. TXA and its predecessor have been used in surgery for decades. Of course they have. It’s a drug that stops bleeding! Today we’ll discuss the use of TXA and why you should probably be using it more.

Paper of the Week

Adverse Events During a Randomized Trial of Ketamine Versus Co-Administration of Ketamine and Propofol for Procedural Sedation in a Pediatric Emergency Department. Weisz, K. et al. J. Emerg. Med April 2017

Link

Medbox

The Partially Examined Life podcast

Philosophy is a fascinating thing. The people at PEL take the time every week to discuss philosophy and the people that make it. This month they’re analyzing the works of Spinoza, which is super interesting.