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Retrospective analysis of tranexamic acid administration in French war-wounded between October 2016 and September 2020
  1. Thibault Pinna1,
  2. N Py2,
  3. L Aigle3,
  4. S Travers4,
  5. P Pasquier5 and
  6. N Cazes6
  1. 1Service des urgences, Hôpital d'Instruction des Armées Laveran, Marseille, France
  2. 2Service d'anesthésie-réanimation, HIA Percy, Clamart, France
  3. 3État-major, Écoles militaires de Santé Lyon-bron, Bron, France
  4. 4Division santé, Brigade de Sapeurs-Pompiers de Paris, Paris, France
  5. 51ère chefferie du service de santé - forces spéciales, Service de santé des armées, Villacoublay, France
  6. 6Emergency Medical Service, Bataillon de Marins-Pompiers de Marseille, Marseille, France
  1. Correspondence to Dr N Cazes, Emergency medical service, Bataillon de Marins-pompiers de Marseille, Marseille, Provence-Alpes-Côte d'Azur, France; md.ncazes{at}


Introduction Since 2013, the French Army Health Service, in agreement with international experts, has recommended the administration of 1 g of tranexamic acid (TXA) in trauma patients in haemorrhagic shock or at risk of bleeding within 3 hours of the trauma.

Methods The aim of this analysis was to describe the administration of TXA in French military personnel wounded during military operations in the Sahelo-Sahelian band between October 2016 and September 2020. Data were collected from forward health records and hospital data from the French hospital where the casualty was finally evacuated. Underuse of TXA was defined as the lack of administration in casualties who had received a blood transfusion with one or more of red blood cells, low-titre whole blood or French lyophilised plasma within the first 24 hours of injury and overuse as its administration in the non-transfused casualty.

Results Of the 76 patients included, 75 were men with an average age of 28 years. Five patients died during their management. 19 patients received TXA (25%) and 16 patients were transfused (21%). Underuse of TXA occurred in 3 of the 16 patients (18.8%) transfused. Overuse occurred in 6 of 60 (10%) non-transfused patients.

Conclusion The analysis found an important underuse of TXA (almost 20%) and highlighted the need for optimising the prehospital clinical practice guidelines to aid prehospital medical practitioners more accurately in administering TXA to casualties that will require blood products.

  • trauma management
  • adverse events
  • trauma management

Data availability statement

No data are available.

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  • Correction notice This article has been corected since it first published. Figure 1, UNDERUSE has been updated to OVERUSE under "6 casualties receive TXA".

  • Contributors TP and NC conceptualised and wrote the original draft and the final manuscript. TP, NC and NP made data curation and were in charge of the project administration. LA managed the investigation and resources. NC and PP managed the analysis. ST and PP supervised, validated, reviewed and edited the final manuscript. Finally NC acting as guarantor of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.