Annal of Emergency Medicine

Does Oral or Topical Tranexamic Acid Control Bleeding From Epistaxis?

Rachel E. Bridwell, MD (EBEM Commentator), Michael D. April, MD, DPhil (EBEM Commentator), Brit Long, MD (EBEM Commentator)

Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX

Compared with usual care, either oral or topical tranexamic acid reduces the risk of rebleeding within 7 to 10 days among adults with epistaxis. A higher proportion of patients demonstrate bleeding cessation within 10 minutes with topical tranexamic acid compared with other topical hemostatic agents.


Managing the Out-of-Hospital Extraglottic Airway Device

Darren Braude, MD, EMT-Pa,c,∗,

Extraglottic devices (commonly referred to as supraglottic airways) are often placed in the out-of-hospital setting either as a primary airway or after a failed attempt at intubation.1–4 They may be used in any critically ill patient with the need for airway management, including those with cardiac arrest, trauma, medication or drug toxicity, pneumonia, and pulmonary edema. Recent evidence from 2 large, international, randomized controlled trials suggests that extraglottic device placement may be the preferred airway management strategy for out-of-hospital cardiac arrest,3,4 which likely means that more patients will arrive in emergency departments (EDs) with extraglottic devices in place in the near future.




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