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Emergency Medical Minute


Oct 16, 2023

Contributor: Aaron Lessen MD

Educational Pearls:

  • Tranexamic acid (TXA) is a common medication to achieve hemostasis in a variety of conditions

  • Patients visiting the ED for gross hematuria (between March 2022 and September 2022) were treated with intravesical TXA

    • 1 g tranexamic acid in 100 mL NS via Foley catheter

    • Clamped Foley for 15 minutes

    • Subsequent continuous bladder irrigation, as is standard in most EDs

  • Compared with a cohort of patients visiting the ED for a similar concern between March 2021 and September 2021, the TXA patients had:

    • A shorter median length of stay in the ED (274 min vs. 411 mins, P < 0.001).

    • A shorter median duration of Foley catheter placement (145 min vs. 308 mins, P < 0.001)

    • Fewer revisits after ED discharge (2.3% vs. 12.3%, P = 0.031)


1. Choi H, Kim DW, Jung E, et al. Impact of intravesical administration of tranexamic acid on gross hematuria in the emergency department: A before-and-after study. Am J Emerg Med. 2023;68:68-72. doi:10.1016/j.ajem.2023.03.020

Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII