ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2019
Development of a nurse-led tranexamic acid administration protocol for trauma patients in rural South Africa.
Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed, 4 citations in OpenAlex.
- Guest Editorial: Introduction to the Trauma Special Issue.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2019Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAdministration of tranexamic acid (TXA) has been shown to effectively reduce all-cause mortality in trauma patients when given within three hours of injury. We found that many trauma patients in our hospital were not receiving TXA. This was due to a variety of factors, including late presentation to hospital, lack of staff awareness, short staffing, and unavailable drugs or equipment. Our aim was to develop a protocol for safe, nurse-led administration of TXA in the emergency centre in order to increase the number of eligible patients treated.
methodsWe developed a protocol based on the inclusion criteria of the CRASH-2 study, opting to use physiological observations along with criteria from the South African Triage Scale to allow nursing staff to identify patients with, or at risk of, significant haemorrhage. We tailored the protocol to the equipment and training available in our poorly resourced rural healthcare setting.
resultsIn a two-month period, 14 patients were given TXA by nurses before the arrival of a doctor. 13/14 (92.9%) were deemed appropriate, with 1/14 (7.1%) deemed inappropriate due to the time since injury. 12/13 (92.3%) patients received the correct infusion dose, with 1/13 (7.7%) only receiving the infusion once the doctor arrived. No adverse events were reported.
conclusionsNursing staff in resource poor rural settings can use a protocol based on the South African Triage Scale and the CRASH-2 study to safely administer TXA to trauma patients. We believe this to be the first published literature on nurse-led administration of TXA. Mortality from trauma may be reduced in rural settings by the timely administration of TXA in the prehospital and rural primary healthcare settings.
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