In the CRASH-2 trial, tranexamic acid given to trauma patients with significant haemorrhage was shown to reduce mortality most effectively when administered within:

• A 3 hours of injury ✓
• B 30 minutes of injury
• C 1 hour of injury
• D 6 hours of injury

Explanation

The CRASH-2 trial demonstrated that tranexamic acid (TXA) reduces mortality from bleeding in trauma patients when given within 3 hours of injury. The benefit was greatest when administered within 1 hour, with a smaller but still significant benefit up to 3 hours. After 3 hours, TXA actually increased mortality, likely due to its pro-fibrinolytic paradox. Current ATLS and military guidelines recommend early TXA (1g IV over 10 minutes then 1g over 8 hours) within 3 hours of injury in all trauma patients with significant haemorrhage.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.