Q. Why does JRCALC deviate from NICE, and recommend 1 gram dose of TXA for head injuries whereas NICE recommend 2 grams?
A. Both JRCALC and NASMeD leads had a number of discussions around TXA and dosage, and reviewed NICE guidance, the available evidence and the strength of that evidence, and also consulted with experts including those on the NICE group for expert opinion.
On review of the evidence, it was felt that there was no robust evidence that a 2 gram dose is superior to the 1 gram dose.
The pharmacological data/evidence shows that inhibition of fibrinolysis is readily achieved by a 1 gram dose.
Also, the main emphasis should be on administering a 1g dose as early as possible. TXA can be given via the IM route and transport the patient to hospital quickly with minimum time spent on scene.
On review of the evidence, it was felt that there was no robust evidence that a 2 gram dose is superior to the 1 gram dose.
The pharmacological data/evidence shows that inhibition of fibrinolysis is readily achieved by a 1 gram dose.
Also, the main emphasis should be on administering a 1g dose as early as possible. TXA can be given via the IM route and transport the patient to hospital quickly with minimum time spent on scene.