Paramedic management of out-of-hospital postpartum haemorrhage with TXA

Background: As a result of some of the factors discussed within this systematic review, UK Paramedics are more likely to manage postpartum haemorrhage (PPH) within the out-of-hospital setting. This systematic review attempts to address the question: ‘Is it suitable for TXA to be implemented within the UK paramedic management of out-of-hospital PPH?’ Methods: Randomised control trials (RCTs) focusing on the effect of TXA upon blood loss during PPH were included within this review. A search strategy was created and applied to databases. Critical analysis of the included studies was carried out, and data were presented within tabular format and discussed through the use of narrative synthesis. Results: Eight RCTs were included within this systematic review. All studies found a significant reduction in the volume of blood loss during PPH when TXA was administered. Discussion: Although TXA was found to significantly reduce the volume of blood loss during PPH, existing evidence is insufficient to support its use within the UK paramedic out-of-hospital management of PPH. Without the presence of studies which are solely focused on the target population, it is difficult to generalise the findings directly to the UK out-of-hospital paramedic management of PPH. This systematic review does however support and supplement the findings of past and current research based upon the relationship between TXA and PPH.