So an incredibly important paper, CRASH-3, has just been published in the Lancet, which looks at the treatment of head injuries with Tranexamic Acid (TXA).

TXA has been shown to save lives in trauma patients at the risk of major haemorrhage, with the notable exclusion of those with head injuries, CRASH-2. TXA has been shown to save lives in those with post parts haemorrhage, WOMAN trial. Time to treatment with TXA has been shown to be hugely influential in it’s ability to decrease blood loss and save lives. So has TXA now been shown to save lives in head injuries?

In this episode we run through the paper and are lucky enough to have an interview with the lead author, Professor Ian Roberts.

Have a listen, read the paper and as always we’d love to hear any thoughts or comments you have on the website and via twitter, and take a look at the references below to draw your own conclusions.


SimonRob & James


Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. The CRASH-3 trial collaborators. Lancet. 2019

The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Roberts I. Health Technol Assess. 2013

CRASH-2; The Bottom Line

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. WOMAN Trial Collaborators.Lancet 2017

WOMAN Trial; The Bottom Line

Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients. Gayet-Ageron A. Lancet. 2017

Tranexamic Acid – The Mechanism of Action; Video

Tranexamic Acid, Time to Treatment; The Resus Room

Does earlier TXA save lives? St Emlyns



Professor Ian Roberts

CRASH-3; StEmlyns




CRASH-3; EMLitofnote



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