title: CRASH-2 Study of Tranexamic Acid to Treat Bleeding in Trauma Patients: A Controversy Fueled by Science and Social Media.
abstract: This paper reviews the application of tranexamic acid, an antifibrinolytic, to trauma. CRASH-2, a large randomized controlled trial, was the first to show a reduction in mortality and recommend tranexamic acid use in bleeding trauma patients. However, this paper was not without controversy. Its patient recruitment, methodology, and conductance in moderate-to-low income countries cast doubt on its ability to be applied to trauma protocols in countries with mature trauma networks. In addition to traditional vetting in scientific, peer-reviewed journals, CRASH-2 came about at a time when advances in communication technology allowed debate and influence to be leveraged in new forms, specifically through the use of multimedia campaigns, social media, and Internet blogs. This paper presents a comprehensive view of tranexamic acid utilization in trauma from peer-reviewed evidence to novel multimedia influences.
authors.affiliation: Department of Emergency and Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA.
authors.forename: Sophia
authors.initials: S
authors.lastname: Binz
authors.affiliation: College of Osteopathic Medicine, Des Moines University, Des Moines, IA 50312, USA.
authors.forename: Jonathon
authors.initials: J
authors.lastname: McCollester
authors.affiliation: Trauma Center, Memorial Hospital, South Bend, IN 46601, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Department of Emergency and Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Miller
authors.affiliation: Section of Trauma and Critical Care, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Pohlman
authors.affiliation: Indiana Blood Center, Indianapolis, IN 46227, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Waxman
authors.affiliation: Trauma Center, Memorial Hospital, South Bend, IN 46601, USA ; University of Notre Dame, Notre Dame, IN 46556, USA.
authors.forename: Faisal
authors.initials: F
authors.lastname: Shariff
authors.affiliation: Trauma Center, Memorial Hospital, South Bend, IN 46601, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Tracy
authors.affiliation: Trauma Center, Memorial Hospital, South Bend, IN 46601, USA ; Indiana University School of Medicine, Notre Dame Campus, South Bend, IN 46556, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Walsh