In the latest edition of Air Medical Journal the British Columbia Ambulance Service’s AirEvac And Critical Care Operations has published a case series detailing the use of tranexamic aid by flight paramedics.
The abstract for the paper can be found HERE. The paper details 13 patients who recieved TXA over a 4 month period, with 9 patients from MVAs, 3 patients who had fallen, and one industrial accident. The average time to administration of TXA from first patient contact was 32 minutes. No complications were reported.
The authors make the point that while tranexamic acid in theory has more benefit in major trauma the earlier it is administered, the importance of it should not be overplayed. Its use occurs in their protocol after a primary survey has occurred, critical interventions have been done, and transport has been initiated. They also mention several cases where the patient met the criteria for TXA use but it was not administered, as the practitioners (who were balancing critical interventions, resuscitation, and short flight times) felt other elements of care had to take priority.