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Tranexamic acid is an antifibrinolytic agent that may reduce acute hemorrhage through inhibition of plasminogen. Newer research suggests that coagulopathy, specifically fibrinolysis, may contribute significantly to the pathology of acute hemorrhage. Methods: We searched the PubMed database for relevant articles from 2000 to 2018 for the terms \u201ctranexamic acid,\u201d \u201cTXA,\u201d \u201cantifibrinolytic,\u201d \u201chyperfibrinolysis,\u201d and \u201ccoagulopathy.\u201d Our search was limited to studies published in the English language. Results: A total of 53 studies were included in this review. These articles suggest a potential role for tranexamic acid in the management of acute intracranial hemorrhage, epistaxis, hematuria, postpartum hemorrhage, gastrointestinal hemorrhage, and trauma-related hemorrhage. A theoretical risk of thrombotic events following tranexamic acid use exists, though large clinical trials suggest this risk remains exceedingly small. Conclusions: Recent studies suggest a mortality benefit with tranexamic acid following acute hemorrhage. First responders such as emergency medical technicians and emergency department clinicians should consider tranexamic acid as an adjunct therapy in the management of acute, severe traumatic and nontraumatic hemorrhage.<\/jats:p>","DOI":"10.1177\/0018578720906613","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T01:44:52Z","timestamp":1581644692000},"page":"350-358","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["The Role of Tranexamic Acid in the Management of an Acutely Hemorrhaging Patient"],"prefix":"10.1177","volume":"56","author":[{"given":"Steven","family":"Davis","sequence":"first","affiliation":[{"name":"The George Washington University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aria","family":"Nawab","sequence":"additional","affiliation":[{"name":"The George Washington University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiaan","family":"van Nispen","sequence":"additional","affiliation":[{"name":"The George Washington University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8440-8454","authenticated-orcid":false,"given":"Ali","family":"Pourmand","sequence":"additional","affiliation":[{"name":"The George Washington University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"bibr1-0018578720906613","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1705649"},{"key":"bibr2-0018578720906613","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61224-0"},{"key":"bibr3-0018578720906613","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0b013e3181b8569d"},{"key":"bibr4-0018578720906613","doi-asserted-by":"publisher","DOI":"10.1038\/nature08780"},{"key":"bibr5-0018578720906613","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001585"},{"key":"bibr6-0018578720906613","unstructured":"Australian Public Assessment Report for Tranexamic Acid About the Therapeutic Goods Administration (TGA). https:\/\/www.tga.gov.au\/sites\/default\/files\/auspar-cyklokapron.pdf. 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