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Shah Jahan MY, Shamila MA, Nurul Azlean N, Mohd Amin M, Anandakumar K, Ahmad Ibrahim KB, Ahmad Tajuddin MN, Aik Howe T, Md Saed M, Fatahul Laham M, Ridzuan MI, Mohd Idzwan Z, Mohd Khairizam MY, Mathew J, Fitzgerald M, Sabariah Faizah J, Kiat Kee G. Administration of tranexamic acid for victims of severe trauma within pre-hospital care ambulance services (PHCAS) in Malaysia. Med J Malaysia 2019; 74:300-306. [PMID: 31424037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Trauma is a Global threat and the 5th highest cause of all-cause mortality in Malaysia caused predominantly due to road traffic accidents. Majority of trauma victims are young adults aged between 21-40 years old. In Malaysia, 24 out of 100,000 population die annually due to trauma, rating us amongst the highest in South East Asia. These alarming figures justify aggressive preventive and mitigation strategies. The aim of this paper is to promote the implementation of evidence-based interventions that will reduce the rate of preventable death because of trauma. Tranexamic acid is one of the few interventions in the early management of severe trauma with level-one evidence. Tranexamic acid has been proven to reduce all causes of mortality and mortality due to bleeding. Evidence proves that it is most effective when administered early, particularly within the 1st hour of trauma. This proposed guideline is formulated based upon quality evidence from multicentre studies, clinical practices in other countries and consideration of the local demographic factors with the intent of enabling an easy and simple pathway to administer tranexamic acid early in the care of the severely injured. CONCLUSION The guideline highlights select pre-hospital criteria's and the methods for drug administration. The authors recognise that some variants may be present amongst certain institutions necessitating minor adaptations, nevertheless the core principles of advocating tranexamic acid early in the course of pre-hospital trauma should be adhered to.
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Affiliation(s)
- M Y Shah Jahan
- Hospital Kuala Lumpur, Emergency Department, Kuala Lumpur, Malaysia.
| | - M A Shamila
- Hospital Ampang, Emergency Department, Ampang, Selangor, Malaysia
| | - N Nurul Azlean
- Hospital Sungai Buloh, Emergency Department, Sungai Buloh, Selangor, Malaysia
| | - M Mohd Amin
- Hospital Sultanah Aminah, Emergency Department, Johor Bahru, Johor, Malaysia
| | - K Anandakumar
- Hospital Banting, Emergency Department, Banting, Selangor, Malaysia
| | | | - M N Ahmad Tajuddin
- Hospital Tengku Ampuan Rahimah, Emergency Department, Klang, Selangor, Malaysia
| | - T Aik Howe
- Hospital Pulau Pinang, Emergency Department, Pulau Pinang, Malaysia
| | - M Md Saed
- Hospital Sultanah Aminah, Emergency Department, Johor Bahru, Johor, Malaysia
| | - M Fatahul Laham
- Hospital Sultanah Bahiyah, Emergency Department, Alor Setar, Kedah, Malaysia
| | - M I Ridzuan
- Hospital Ampang, Emergency Department, Ampang, Selangor, Malaysia
| | - Z Mohd Idzwan
- University Malaya Medical Center, Kuala Lumpur, Malaysia
| | | | - J Mathew
- Trauma Services, The Alfred, Melbourne, Australia
| | - M Fitzgerald
- Trauma Services, The Alfred, Melbourne, Australia
| | - J Sabariah Faizah
- Hospital Sungai Buloh, Emergency Department, Sungai Buloh, Selangor, Malaysia
| | - G Kiat Kee
- Hospital Sultanah Aminah, Emergency Department, Johor Bahru, Johor, Malaysia
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