• 1 Hospital Kuala Lumpur, Emergency Department, Kuala Lumpur, Malaysia.
  • 2 Hospital Ampang, Emergency Department, Ampang, Selangor, Malaysia
  • 3 Hospital Sungai Buloh, Emergency Department, Sungai Buloh, Selangor, Malaysia
  • 4 Hospital Sultanah Aminah, Emergency Department, Johor Bahru, Johor, Malaysia
  • 5 Hospital Banting, Emergency Department, Banting, Selangor, Malaysia
  • 6 Hospital Kuala Lumpur, Emergency Department, Kuala Lumpur, Malaysia
  • 7 Hospital Tengku Ampuan Rahimah, Emergency Department, Klang, Selangor, Malaysia
  • 8 Hospital Pulau Pinang, Emergency Department, Pulau Pinang, Malaysia
  • 9 Hospital Sultanah Bahiyah, Emergency Department, Alor Setar, Kedah, Malaysia
  • 10 University Malaya Medical Center, Kuala Lumpur, Malaysia
  • 11 Trauma Services, The Alfred, Melbourne, Australia
Med J Malaysia, 2019 08;74(4):300-306.
PMID: 31424037


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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.