Project summary
Clinical Randomisation of an Anti-fibrinolytic in Symptomatic mild Head injury in older adults
The most common cause of major trauma in older adults in the UK is a fall from standing. Traumatic brain injury accounts for half of trauma admissions and is a large cause of death and disability. 90% of the traumatic brain injuries seen each year are termed as mild, however older adults have worse outcomes from these than younger patients. Due to the increased use of anticoagulant and antiplatelet medications, older adults are more likely to suffer from a bleed on the brain. Traumatic brain injury is also a strong risk factor for dementia.
CRASH-4 is investigating an early injection of tranexamic acid, which stops bleeding by preventing the breakdown of clots on intracranial haemorrhage, disability, death and dementia in older adults who are symptomatic following a head injury.
Patients who are attended by a trial trained Paramedic or Ambulance Nurse will either receive Tranexamic Acid or Placebo.
How are patients selected for this project?
Patients who meet the eligibility criteria above and are attended by a trial trained clinician will be offered the opportunity to be a part of this trial.
Closing date
End of recruitment is currently 30 November 2025
Patient Group
- Age 50 and older.
- Injury within 3 hours
- History or evidence of a head injury
- Glasgow coma score of 13 or more
- Has one or more of the following symptoms
- Has or had impaired consciousness (Loss of consciousness, amnesia or confusion)
- Nausea or vomiting
- Must be admitted to a participating hospital.
- Cannot live in a nursing home, mental health institute or prison
- Cannot be receiving tranexamic acid due to major bleeding and cannot be contra-indicated for tranexamic acid (Allergic reaction, suspected acute arterial or venous thrombosis).
Participating areas in SCAS
Patients across the South-Central area have the potential to be offered participation into this trial if they are in the following areas.
- Milton Keynes
- Oxford
- Eastleigh
- Southampton
- Portsmouth
- Petersfield
- Bracknell
- Reading
Only Clinical staff who have completed the CRASH4 trial training working in these areas are eligible to be included. As patients will require transportation to a participating hospital.
- Milton Keynes University Hospital
- Stoke Mandeville Hospital
- Horton General Hospital
- John Radcliffe Hospital
- Great Western Hospital
- Royal Berkshire Hospital
- University Hospital Southampton
- Queen Alexandra Hospital
- Royal Bournemouth Hospital