• Matthew Warner, Jonathon Lowe, and Ed Benjamin Graham Barnard.
• Emergency Department, British Antarctic Survey Medical Unit, Plymouth, UK.
• Emerg Med J. 2025 Jan 30.

AbstractThe early administration of tranexamic acid is recognised as significantly reducing mortality in traumatically injured patients with major haemorrhage, typically given via intravenous or intramuscular routes. In the context of mass casualty events, there may exist multiple traumatically injured casualties that would benefit from tranexamic acid, however, it's administration may be delayed through the need to establish intravenous access. Additionally, if the initial assessment of the traumatically injured casualty is undertaken by an individual who cannot administer intravenous or intramuscular medications, time to administration will be further delayed. This concepts paper seeks to discuss the potential for utilising oral tranexamic acid, in the context of mass casualty events, as an alternative administration route.© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

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