This is EM cases, EM Quick Hits podcast, where our team of experts and educators bring

a clear, concise, and condensed, practice-changing knowledge on all those EM topics

you may not be totally comfortable with. Cases, the latest

evidence, procedural tips and tricks, pitfalls to avoid, and the key take-home points and

references on the EM cases website. Quick, let's get on with it. First up, we have Salim Rosey on

the halted trial. That's TXA for unstable GI bleeds. Now, it seems like TXA has been the flavor of the

past couple of years for just about everything from trauma to epistaxis to homoptosis. But the question

is, does it work for GI bleed? Let's find out.

Hey, EMKCases listeners. This is Salim Rizai back at you again with another best of Rebel EM.

This past month, we covered a paper called The Halted trial looking at tranlexemic acid in acute GI bleeds.

Now, there's a myriad of pharmaceutical options,

including PPIs, somatostatin analogs, antibiotics, as well as blood products that can be instituted as part of the acute resuscitation of these patients. Now, the role of tranexemic acid

and resuscitation of this condition is really unknown.

It has become one of the darling medications of emergency medicine with numerous indications,

minimal side effect profile, and a low cost.

TXA works by inhibiting blood clot breakdown.

It has been shown to decrease death from bleeding in other conditions

such as trauma and postpartum hemorrhage, but there's very limited evidence for its use in

GI bleed. A systematic review and meta-analysis of seven randomized trials with just over

1,600 patients showed a reduction in all-cause mortality. However, the individual trials were small

and prone to a myriad of biases making these conclusions, hypothesis generating at best.

The paper we're going to be covering today is by the Haltit trial collaborators, effect of

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