Just posting this article here to stimulate some discussion. Now that we sprinkle TXA on basically any body part, we need to be sure to maintain evidence based medicine. I would point out that there is very little downside to TXA. He mentions the HALT-IT trial that DID show a higher rate of VTE events in the treatment group. But most TXA studies have not shows risk of clotting. We also must be aware of the regression to the mean issue, which is probably what occurred in the most recent epistaxis study. For a book that covers this nicely, see this gem.

Again, I am a fan of TXA, and open to attempting treatment modalities with new, not yet gold standard of care evidence. But we must always practice non-maleficence, and must not be tempted by indication creep.

-Huecker