Guyette FX, Brown JB, Zenati MS, et al. - Researchers examined if patients at risk for hemorrhage after trauma exhibit lower 30-day mortality in correlation with prehospital administration of tranexamic acid vs placebo. They conducted a multicenter randomized clinical trial including 927 injured patients with prehospital hypotension (systolic blood pressure ≤ 90 mm Hg) or tachycardia (heart rate ≥ 110/min) before arrival at 1 of 4 US level 1 trauma centers, within an estimated 2 hours of injury, from May 1, 2015, through October 31, 2019. Outcomes suggested no significantly lower rate of 30-day mortality for patients receiving tranexamic acid vs placebo in the prehospital setting (8.1% vs 9.9%). In addition, the arms did not differ in the incidence of pulmonary embolism, deep vein thrombosis, seizures, or adverse events, including thrombotic complications. Although prehospital administration of tranexamic acid was identified as safe, it did not produced significant reduction in mortality in patients at risk for hemorrhage after injury.