Trauma INTACT

TXA, a drug that prevents severe bleeding after injury by inhibiting blood clot breakdown, is most effective when given soon after injury. Every 15 minutes treatment delay reduces its lifesaving potential by 10%. However, currently only 3% of UK trauma victims get TXA within an hour of injury.

The drug is usually given by intravenous injection (IV) but securing an intravenous line can take time and the drug has to be injected slowly. In many countries, pre-hospital care is provided by people who cannot give intravenous injections.

This trial examined the pharmacokinetics of intramuscular TXA in bleeding trauma patients.

Intramuscular TXA is well tolerated with only mild and transient injection site reactions. Intramuscular TXA is rapidly absorbed, reaching therapeutic concentrations within 15 minutes. Blood lactate and signs of shock had no apparent impact on the rate of absorption.

This research could have major implications for trauma care, particularly in low- and middle-income countries where intramuscular TXA could be given by first responders, greatly expanding access to urgent treatment. This could improve trauma care around the world, especially in low- and middle-income countries where most trauma deaths occur.